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Of special note, Vermont has collaborated with all of the other New England states as a member of PEGASUS (Pediatric Evidence Based Guidelines: Assessment of EMS System Utilization in States) to incorporate the best evidence-based pediatric care into our protocols.  The PEGASUS project offers Vermont and the other New England states an opportunity to better coordinate patient care over a large region and to bring each New England state’s protocols to a more uniform content.  The PEGASUS project will create the largest US population cared for under common EMS protocols, will improve patient care and offer a unique opportunity to learn about the value and importance of prehospital medicine.  The EMS Office licenses EMS organizations, provides ambulance inspections, administers certification exams for EMS providers and is active in system development and injury prevention programs.  Vermont’s Emergency Medical Services System (EMS) is composed of approximately 180 licensed First Response and Ambulance services staffed by 3,000 certified EMS providers.  These protocol updates are a significant step forward for EMS care in Vermont and represent the work of many people across the state.  Specific feedback has been received from all 13 District Medical Advisors, numerous stakeholder groups, and a multitude of EMS providers, agencies and districts across the State.  The Vermont Office of EMS and Injury Prevention is the state office responsible for EMS regulation and system development.  These pre-hospital emergency care providers include First Responders/Emergency Care Attendants, EMT Basics, EMT Intermediates and Paramedics.  We welcome you to the 2020 update to the Vermont Statewide EMS Protocols.  Whenever possible, protocol updates have been guided by the most recent and best evidence-based EMS literature.  The majority of our EMS providers are volunteers.