MEFIRS Updates May 4, 2026

There are a number of system updates planned for May 4, 2026.

Medications Ordered

A new panel will be created on the EMS Patient Care Report under the Treatment Section named Orders. The panel will contain a Medications Ordered grid to allow clinicians to document medications ordered. There will be no validation rules for these fields. The fields in the grid will include:

• Medication Ordered (itMedicationOrdered.001)
• Medication Ordered By (itMedicationOrdered.002)
• Medication Ordered Dosage (itMedicationOrdered.003)
• Medication Ordered Dosage Units (itMedicationOrdered.004)
• Medication Ordered Route (itMedicationOrdered.005)
• Medication Ordered Date/Time (itMedicationOrdered.007)
• Medication Ordered Comments (itMedicationOrdered.008)

A new panel will be created on the Community Health encounter form under the Treatments Section named Orders. The panel will contain a Medications Ordered grid to allow clinicians to document medications ordered. There will be no validation rules for these fields. The fields in the grid will include:

• Medication Ordered (itMedicationOrdered.001)
• Medication Ordered By (itMedicationOrdered.002)
• Medication Ordered Dosage (itMedicationOrdered.003)
• Medication Ordered Dosage Units (itMedicationOrdered.004)
• Medication Ordered Route (itMedicationOrdered.005)
• Medication Ordered Date/Time (itMedicationOrdered.007)
• Medication Ordered Comments (itMedicationOrdered.008)

Procedures Ordered

A new panel will be created on the EMS Patient Care Report under the Treatment Section named Orders. The panel will contain a Procedures Ordered grid to allow clinicians to document procedures ordered. There will be no validation rules for these fields. The fields in the grid will include:

• Procedure Ordered (itProcedureOrdered.001)
• Procedure Ordered By (itProcedureOrdered.002)
• Procedure Ordered Size of Equipment (itProcedureOrdered.003)
• Procedure Ordered Date/Time (itProcedureOrdered.004)
• Procedure Ordered Comments (itProcedureOrdered.005)
• Procedure Ordered Location (itProcedureOrdered.006)
• Procedure Ordered Response (itProcedureOrdered.007)

A new panel will be created on the Community Health encounter form under the Treatments Section named Orders. The panel will contain a Procedures Ordered grid to allow clinicians to document procedures ordered. There will be no validation rules for these fields. The fields in the grid will include:

• Procedure Ordered (itProcedureOrdered.001)
• Procedure Ordered By (itProcedureOrdered.002)
• Procedure Ordered Size of Equipment (itProcedureOrdered.003)
• Procedure Ordered Date/Time (itProcedureOrdered.004)
• Procedure Ordered Comments (itProcedureOrdered.005)
• Procedure Ordered Location (itProcedureOrdered.006)
• Procedure Ordered Response (itProcedureOrdered.007)

Update for Togus as Destination Facility

Validation rules that require an Encounter Number and Medical Record Number will exempt the facility VA HEALTHCARE SYSTEM - TOGUS.

NEMSIS v.3.5.1 Update

Maine EMS implemented the NEMSIS v3.5.0 data standard in January of 2025. NEMSIS has since issued a minor release update, v3.5.1 and ImageTrend has achieved compliance with the minor release. There are several changes to the PCR for v3.5.1 that are being implemented on May 4, 2026. Once implemented agencies using exports to third parties, such as billing vendors and other data exchanges, should confirm with the third party they are capable of accepting NEMSIS v3.5.1 data before changing their export to use v.3.5.1.

• Remove Patient Generation ( itPatient.003) and add PersonNameSuffix (ePatient.23)
• (1513013) Middle East or North African will be added to EMS Personnel's Race (dPersonnel.13) in MEFIRS and Licensure
• Sign Language will be added to EMS Personnel's Foreign Language Ability (dPersonnel.20) in MEFIRS and Licensure
• Two pertinent negatives will be enabled for Date/Time of Cardiac Arrest (eArrest.14)
  • 8801029 Approximate
  • 8801023 Unable to Complete
• There are two label changes that will be made to Transport Disposition (eDisposition.30) to improve clarity:
  • 4230005 Transport by Another EMS Unit will be changed to Transport by Another EMS Unit/Agency
  • 4230007 Transport by Another EMS Unit, with a Member of This Crew will be changed to Transport by Another EMS Unit/Agency, with a Member of This Crew
• Back and Spine Assessment Finding Location (eExam.13) will have two new values added:
  • 3513029 Flank-Left
  • 3513031 Flank-Right
• Extremities Assessment (eExam.16) will have seven (7) new values added
  • 3516085 Cool/Cold to Touch
  • 3516087 Cyanosis
  • 3516089 Erythema/Flushing
  • 3516091 Hot/Warm to Touch
  • 3516093 Lividity
  • 3516095 Mottled
  • 3516097 Pale
• Alcohol/Drug Use Indicators (eHistory.17) will have one (1) value removed and two (2) values added
  • it3117.004 Bystanders/Family Report Drug/Alcohol Use will be removed
  • 3117015 Bystander/Family Reports Drug Use will be added
  • 3117017 Bystander/Family Reports Alcohol Use will be added
• A new element, Medication Administered by Another Unit (eMedications.13), will be added with values of Yes or No. The new element indicates the medication was administered by someone other than the EMS clinicians in this EMS unit. This is not for prior to arrival medications, but for medications administered when multiple units/caregivers are on scene simultaneously providing patient care. The data element will be added to the form in several places:
  • Treatment>Medication Administrations
  • Cardiac Arrest>Treatment>Cardiac Arrest Medications>Oxygen
  • Cardiac Arrest>Treatment>Cardiac Arrest Medications>EPINEPHrine 1Mg/10ML (1:10,000)
  • Cardiac Arrest>Treatment>Cardiac Arrest Medications>Amiodarone
  • Cardiac Arrest>Treatment>Cardiac Arrest Medications>Sodium Bicarbonate
  • Cardiac Arrest>Treatment>Cardiac Arrest Medications>Magnesium Sulfate
  • Cardiac Arrest>Treatment>Cardiac Arrest Medications>Calcium Gluconate
  • Cardiac Arrest>Treatment>Cardiac Arrest Medications>IV Fluid Bolus
• The Type of Work-Related Injury, Death or Suspected Exposure (eOther.06) will have six (6) new values added
  • 4506031 Violence-Offensive, Intimidating, or Hateful Language
  • 4506033 Violence-Physical Threat, or Threatening Behavior
  • 4506035 Violence-Physical Attack or Attempt to Attack
  • 4506037 Violence-Unwelcome Sexual Attention, Remarks, Jokes or Gestures
  • 4506039 Violence-Unwanted Touching of a Sexual Nature
  • 4506041 Struck by Vehicle Along Roadway
• (2514013) Middle East or North African will be added to Race (ePatient.14) in MEFIRS
• Name Suffix (ePatient.23) will replace Patient Generation (itPatient.003) on the Arrival>Patient Information panel of the EMS PCR and added to the Arrival>Patient Name panel of the community health form.
• The new element Patient's Preferred Language (ePatient.24) will replace the supplemental question Patient's Preferred Language. There are numerous values for this new element.
• A new element, Airway Placement Technique (eProcedures.14), will be added to each panel that captures airway procedures. This new element is used to document the manner/equipment used during the placement of the advanced airway. A visiblity rule be added to only show the new data element on Airway procedures. The values for the new element are:
  • 3914001 Blind Digital Technique
  • 3914003 Cross Finger Technique
  • 3914005 Direct Laryngoscopy
  • 3914007 Fiberoptic Laryngoscopy
  • 3914009 Indirect Laryngoscopy
  • 3914011 Video Laryngoscopy
• A new element, Procedure Performed by Another Unit (eProcedures.15), will be added with values of Yes or No. This new element is used to indicate the procedure was performed by someone other than the EMS clinicians in this EMS unit. This is not for prior to arrival procedures, but for procedures performed when multiple units/caregivers are on scene simultaneously providing patient care. Where applicable, default values will be set. The data element will be added to the form in several places:
  • Treatment>Procedures>Procedures Performed
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>CPR Start
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>Mechanical CPR Start
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>BVM Ventilation
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>CPR Stop
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>Defibrillation
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>Airway - NPA
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>Airway - OPA
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>Laryngoscopy (Visualization Only)
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>Oral Intubation
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>Intubation - Video Guided Laryngoscopy
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>Blind Insertion Airway - Transglottic (LMA / I-Gel)
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>Blind Insertion Airway - Periglottic (King Tube)
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>IO Placement
  • Cardiac Arrest>Treatment>Cardiac Arrest Procedures>IV Placement
• Type of Response Delay (eResponse.09) will have a new value, 2209035 Out of Service Area Response
• A new element, Transferred Patient/Care To/From Agency (eScene.25), will be added to the PCR. This new element is used to indicate whether primary responsibility for the care of the patient was transferred in the field to or from the EMS agency listed in Other EMS or Public Safety Agencies at Scene (eScene.02). Received From Agency ID (itDisposition.032) and Transferred To Agency ID (itDisposition.034) will be removed from the form as these are now represented by the new NEMSIS element. Supporting work will also be performed on numerous visibility and validation rules and will replace the current fields Transferred To Agency Id (itDisposition.034) and Patient Received From Agency (itDisposition.032). The Other Agencies On Scene grid will be labeled as Other Agencies. The values for the element are:
  • 2725001 Transferred Patient to Agency
  • 2725003 Received Patient from Agency
  • 2725005 No Transfer of Patient/Care To/From Agency
• Stroke Scale Score (eVitals.34) will be added. The element is the stroke score value associated with the stroke scale type listed in eVitals.30
• Stroke Scale Result (eVitals.29) had a custom label applied of Stroke Scale Score. To avoid confusion with the new NEMSIS element Stroke Scale Score (eVitals.34) the label will be reset to its original value, Stroke Scale Result.