AEMS Blog

Important Central Arizona Regional EMS Guidelines (CAREMSG) Transition Information for Non-Automatic Aid / CAREMDC Agencies
Effective July 1, 2026

Background and Context: Why the Change is Occurring

Earlier this year, the Automatic Aid agencies elected to establish an independent physician consortium and assume responsibility for their own guideline development, review, and update process through the EMS Regional Operations Consistency Committee (ROCC). As a result...

...the Central Arizona Region is transitioning from a single shared guideline library to two independently governed guideline libraries: one for Automatic Aid / ROCC agencies and one for non-Automatic Aid agencies / Central Arizona Regional Medical Directors Consortium (CAREMDC) agencies.

We recognize that this creates added complexity for agencies that previously operated under one regional guideline system. Our focus is to manage this transition as safely and clearly as possible while minimizing disruption for clinicians and agencies.

Important App Transition Information

For Automatic Aid / ROCC Agencies

Beginning July 1, the current CAREMSG app will transition to the ROCC guideline library and will begin receiving content updates approved through the ROCC physician governance process. In addition, the app itself will receive a refresh on July 8 for the Automatic Aid / ROCC agencies that follow those guidelines.

For Non-Automatic Aid Agencies / CARESMDC

Agencies and medical directors that are not part of the Automatic Aid / ROCC group and will continue to participate in the Central Arizona Region EMS Medical Directors Consortium (CAREMDC) will remain under CAREMSG guidelines.

Because the upcoming ROCC guideline changes have not been reviewed or adopted by the medical directors involved with CAREMDC, the ROCC app will no longer serve as the authorized guideline source for Non-Automatic Aid / CAREMDC agencies once ROCC updates are deployed.

CAREMDC Transition to PPP Agency

CAREMDC has secured a way for non-Automatic Aid agencies to continue accessing the CAREMSG guideline library during this transition. Special thanks to Dr. Franco Castro-Marin and Dr. Beth Ranney, the AcidRemap team for helping make this possible on very short notice.

As a result, Non-Automatic Aid / CAREMDC agencies will be able to access the CAREMSG guideline library through PPP Agency while we work through this transition and complete development of the permanent CAREMSG platform.

After Installing PPP Agency

Please refer to the attached screenshots for how to select the correct guideline library within the app. In PPP Agency, the guideline library is identified as a protocol.

1. Open the PPP Agency app
2. Search for CAREMSG
3. Download the CAREMSG guideline library

Once installed, the content should feel very familiar, as it contains the same CAREMSG guideline library currently used by CAREMDC / non-Automatic Aid agencies.

Important Note for iOS Users

Please ask iPhone and iPad users to disable App Offloading in their device settings under iTunes & App Store to help prevent the app from being unexpectedly removed from their device.

Temporary Limitations

This is an interim solution for CAREMDC / non-Automatic Aid agencies while CAREMDC’s permanent platform is being developed. During this temporary transition, two features currently available in the CAREMSG app could not be retained in PPP Agency:

• PediSTAT medication calculators will not be available
• Internal PDF hyperlinks will not function

The table of contents will remain fully usable for navigation.

While not ideal, this solution allows CAREMDC / non-Automatic Aid agencies to continue using the currently approved CAREMSG guideline library while development of the permanent application is completed.

Looking Ahead

CAREMDC’s guideline development and physician oversight work will continue without interruption. We are actively developing a dedicated CAREMSG application that will serve as the permanent platform for CAREMDC / non-Automatic Aid agencies. The new app is expected to include integrated dose calculators, along with additional features intended to improve usability, communication, and education. Our current target is to launch the new application before the end of August.

We recognize that this transition may create confusion, particularly for clinicians who work across multiple systems. Clear and consistent communication from agency leadership will be essential to ensure personnel are referencing the correct guideline library.

Please begin communicating this change to your personnel and encourage them to complete the transition as soon as CAREMSG becomes available within PPP Agency. AcidRemap expects to need a couple of additional days to complete the migration on their end.

Thank you for your patience and partnership as we work through this transition. Our goal remains the same: providing clinicians with a high-quality, evidence-based guideline system supported by a strong physician governance process.

Please distribute this information to your agency members, medical directors, prehospital coordinators, educators, and others who may benefit from it. We appreciate the work of both the Automatic Aid / ROCC and CAREMDC teams, as well as the EMS and hospital medical directors, in continuing to support high-quality patient care throughout the region.