Alert Medic 1 Discussing the 2025 Maryland EMS Protocol Updates w/ Tim Chizmar, MD
Jun 13, 2025
Tim Chizmar, MD, oversees EMS protocols in Maryland and focuses on educating EMS providers. In this discussion, he delves into the 2025 protocol updates, highlighting major changes in trauma care and sepsis management. He emphasizes the introduction of pre-hospital antibiotics and the new guidelines for managing hypertensive disorders in pregnancy. Chizmar also addresses advancements like video laryngoscopy and high-performance CPR, stressing the need for continuous training and timely interventions to improve patient outcomes.
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Start Cefazolin Early For Open Extremity Injuries
- Give cefazolin early for open, mangled, or degloved extremity injuries after immediate resuscitation priorities.
- Avoid cefazolin if the patient has a known penicillin or cephalosporin allergy and document consultation if unsure.
Scene Antibiotics Beat 'Close-To-Hospital' Assumptions
- Time to antibiotic matters more than transport proximity because in-hospital delays push antibiotic timing far beyond scene-to-hospital time.
- Early prehospital antibiotics aim to reduce osteomyelitis and infected bone risk by shortening time-to-antibiotic.
Give TXA Over 3–5 Minutes And Early
- Administer TXA over three to five minutes in most prehospital trauma cases; rapid infusion beyond that is unnecessary.
- Prioritize early TXA within the first hour for best effect, as effectiveness declines with time post-injury.