The EMS Board shall approve and issue the Maryland Medical Protocols for Emergency Medical Services Providers and any protocol revisions or supplemental protocols. MIEMSS shall develop the Maryland Medical Protocols for Emergency Medical Services Providers and any protocol revisions or supplemental protocols with the advice of a protocol review committee. Any individual may recommend a protocol, protocol revision or supplemental protocol to the protocol review committee by forwarding the recommendation to the protocol review committee and the office of the State EMS Medical Director at MIEMSS. MIEMSS shall appoint the protocol review committee which shall be composed of: One representative from each of the following groups: The EMS Board; The State Board of Physicians; The Statewide Emergency Medical Services Advisory Council; The Pediatric Emergency Medical Advisory Committee; The Jurisdictional Advisory Committee; The Commercial Ambulance Service Advisory Committee; The EMS operational program medical directors; Volunteer EMS BLS Providers; Volunteer EMS ALS Providers; Career EMS BLS Providers; Career EMS ALS Providers; Commercial EMS BLS Providers; Commercial EMS ALS Providers; The Maryland Chapter of ACEP; the State Board of Nursing; and Trauma Net; and The regional medical directors. The protocol review committee shall review the fiscal impact of any proposed protocol, protocol revision, or supplemental protocol. All recommendations for protocols, protocol revisions, or supplemental protocols concerning the practice of medicine shall be presented to the Practice of Medicine Committee of the State Board of Physicians. All recommendations for protocols, protocol revisions, or supplemental protocols concerning the practice of nursing shall be presented to the Board of Nursing. The Executive Director of MIEMSS shall present all recommendations for protocols, protocol revisions, or supplemental protocols to the EMS Board. In an emergency situation in which a delay in the issuance of a protocol, protocol revision, or supplemental protocol would pose a threat to the health and welfare of patients, the Executive Director of MIEMSS, with the concurrence of the Chair of the EMS Board, may issue an immediate emergency protocol or revision which shall be effective pending action by the EMS Board at the next meeting of the EMS Board.