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EMS Providers

General information

EMT Certification/Renewal & Paramedic Accreditation

Initial EMT Certificate

*Beginning 4/1/2021 applicants must apply through the online application process*

You should review the Agency’s policy 301 – EMT Certification on EMT certificate and EMT certificate renewals before proceeding with your application.

**Prior to completing any of the steps below, please go to the San Mateo County EMS online certification system and verify your account. If you do not have an account on the system, create one prior to proceeding. Failure to do so prior to initiating the application process may result in substantial delays in processing your application**

Eligibility Requirements

The following requirements apply to all applicants who have never been certified through San Mateo County as an EMT, or whose EMT certificate has been expired for more than 24 months:

  1. Be eighteen (18) years of age or older.
  2. Provide a current government-issued photo ID (e.g., state driver’s license, state ID card, military ID card, passport).
  3. Meet one of the following eligibility criteria:
    • Possess a current and valid National Registry EMT, Advanced EMT, or Paramedic registration certificate; or,
    • Possess a current and valid out-of-state Advanced EMT or Paramedic certificate; or,
    • Possess a current and valid California Advanced EMT certificate or a current and valid California Paramedic license.
  4. Not be precluded from certification for reasons defined in Section 1798.200(c)(1) through (c)(12) of the Health and Safety Code.

Online Application

Once these requirements are met, complete the EMT – Initial Certification online application and pay the established non-refundable fee.

Live Scan Information

Prior to submitting your application, complete a Department of Justice Criminal Offender Record Information (CORI) background check using the San Mateo County Live Scan Request form

The Agency does not release information contained in the Live Scan background report. For information on obtaining a copy of your Live Scan background results, or for information on the status of your Live Scan, contact the California Department of Justice by visiting https://applicantstatus.doj.ca.gov/

Issuance of California EMT Certificate

An application for an initial EMT certificate may take up to 30 days to process from the time the application is complete. Applications that disclose any criminal history or administrative actions against a healthcare license may take up to 60 days to process. Information regarding the status of your application may be found by visiting the online portal.

California EMT Certificate valid Statewide

A California EMT certificate issued by San Mateo County or any other certifying entity is valid statewide. You are not required to obtain a California EMT certificate from San Mateo County EMS to work as an EMT in San Mateo County.

EMT Certificate Renewal

* Beginning 4/1/2021 applicants must apply through the online application process*

You should review the Agency’s policy PER 1 - EMT Certification on EMT certificate and EMT certificate renewals before proceeding with your application.

**Prior to completing any of the steps below, please go to the San Mateo County EMS online certification system and verify your account. If you do not have an account on the system, create one prior to proceeding. Failure to do so prior to initiating the application process may result in substantial delays in processing your application**

Eligibility Requirements

To maintain certification, all candidates must:

  1. Possess a valid and current California EMT certificate.
  2. Complete a minimum of twenty-four (24) hours of approved prehospital continuing education within the two (2) year certification period.
  3. Pay the appropriate fee.

Once these requirements are met:

  • Applicants whose current EMT certificate was issued by San Mateo County EMS must complete the EMT – Recertification (Current or expired less than 12 months) online application.
  • Applicants whose current EMT certification was not issued by San Mateo County EMS must complete the EMT – Recertification (New to San Mateo County) online application.

In order to complete the application, copies of the following documents will need to be uploaded into the system:

  • Current government-issued photo ID (e.g., state drivers license, state ID card, military ID card, passport)
  • If applicable, court records and/or police reports as requested during the application process (these records must be attached to each application submitted, whether the EMS Agency has received them previously or not)

Online applications will not be accepted until all the required documentation has been uploaded.

Once the online application has been submitted and the EMS Agency has confirmed that the applicant meets all the criteria specified in Title 22, Division 9, Chapter 2, Article 5 of the California Health and Safety Code, an individual shall be recertified as an Emergency Medical Technician. This certification is valid throughout the State of California.

If the recertification requirements were met within six (6) months prior to the expiration date, the effective date of the certification shall be the expiration date of the current certification.

Certification cards will be mailed to applicants following verification of documentation submitted with the application.

Expired EMT Certificate

*Beginning 4/1/2021 applicants must apply through the online application process*

You should review the Agency’s policy 301 – EMT Certification on EMT certificate and EMT certificate renewals before proceeding with your application.

**Prior to completing any of the steps below, please go to the San Mateo County EMS online certification system and verify your account. If you do not have an account on the system, create one prior to proceeding. Failure to do so prior to initiating the application process may result in substantial delays in processing your application**

Eligibility Requirements

Requirements for recertification of a lapsed EMT certificate depend on the period of time the certificate has lapsed. Select the appropriate option below, based on the amount of time that the certification has lapsed:

For a lapse of less than six (6) months:

Follow the instructions on the “EMT Certificate Renewal” tab

For a lapse of six (6) months or more, but less than twelve (12) months:

  1. Complete a minimum of thirty-six (36) hours of approved prehospital continuing education within the prior two (2) year period.

Once these requirements are met:

  • Applicants whose current EMT certificate was issued by San Mateo County EMS must complete the EMT – Recertification (Current or expired less than 12 months) online application.
  • Applicants whose current EMT certification was not issued by San Mateo County EMS must complete the EMT – Recertification (New to San Mateo County) online application.

In order to complete the online application, copies of the following documents will need to be uploaded into the system: 

  • Current government-issued photo ID (e.g., state drivers license, state ID card, military ID card, passport)
  • If applicable, court records and/or police reports as requested during the application process (these records must be attached to each application submitted, whether the EMS Agency has received them previously or not)

Upon completion of the appropriate requirements listed above, and confirmation that the applicant meets all the criteria specified in Title 22, Division 9, Chapter 2, Article 5 of the California Health and Safety Code, an individual shall be recertified as an Emergency Medical Technician. This certification is valid throughout the State of California. 

Certification cards will be mailed to applicants following verification of documentation submitted with the application.

For a lapse of twelve (12) months or more, but less than twenty-four (24) months:

  1. Possess a California EMT certificate that is expired for more than twelve (12) months, but less than twenty-four (24) months.
  2. Complete a minimum of forty-eight (48) hours of approved prehospital continuing education within the prior two (2) year period.
  3. Successfully complete the National Registry of Emergency Medical Technicians (NREMT) written and skills exam within the past two (2) years.
  4. Complete a Department of Justice Criminal Offender Record Information (CORI) background check.

Once these requirements are met, complete the EMT – Recertification (Expired over 12 months) online application. 

In order to complete the application, copies of the following documents will need to be uploaded into the system: 

  • Current government-issued photo ID (e.g., state drivers license, state ID card, military ID card, passport)
  • Completed skills competency form EMSA-SCV 1/17
  • If applicable, court records and/or police reports as requested during the application process (these records must be attached to each application submitted, whether the EMS Agency has received them previously or not)

Upon completion of the appropriate requirements listed above, and confirmation that the applicant meets all the criteria specified in Title 22, Division 9, Chapter 2, Article 5 of the California Health and Safety Code, an individual shall be recertified as an Emergency Medical Technician. This certification is valid throughout the State of California. 

Certification cards will be mailed to applicants following verification of documentation submitted with the application.

Paramedic Accreditation

** Beginning 4/1/2021 applicants must apply through the online application process**

You should review the Agency’s policy 302 – Paramedic Accreditation  before proceeding with your application.

Eligibility Requirements

All candidates for paramedic accreditation in San Mateo County shall meet the following accreditation requirements:

  1. Possess a current California paramedic license.
  2. Be employed as a paramedic with a designated San Mateo County ALS service provider or the EMS Agency (i.e. AMR or Fire Service ALS provider).

Once these requirements are met, please complete the Paramedic – Initial Accreditation online application.

In order to complete the application, copies of the following documents will need to be uploaded into the system:

  • Gov’t issued photo ID
  • Current and valid California Paramedic License
  • CPR Certification
  • ACLS Certification
  • PALS/PEPP Certification
  • Prehospital Traumatic Life Support (PHTLS) or International Trauma Life Support (ITLS) Certification
  • If applicable, court records and/or police reports as requested during the application process

Online applications will not be accepted until all the required documentation has been uploaded.

Once the online application has been submitted and the EMS Agency has confirmed that the applicant meets all the criteria specified in Title 22, Division 9, Chapter 4, Article 5, Section 100166 of the California Code of Regulations, an individual shall be accredited as a Paramedic in San Mateo County.

Maintaining Paramedic Accreditation

  1. Paramedic accreditation to practice in San Mateo County shall be continuous if the accredited paramedic meets the following requirements: 
    • Continuously possesses a valid California paramedic license, AHA BLS, ACLS, PALS/PEPP, and a County-approved trauma credential;
    • Maintains continuous employment as a paramedic with a LEMSA authorized ALS service provider or within the LEMSA.
    • Has completed each annual LEMSA required policy, procedure, and protocol update subsequent to attaining initial accreditation.
  2. Complete an electronic application for paramedic reaccreditation through the LEMSA’s online license management system within thirty (30) calendar days of California paramedic licensure renewal;
  3. Continuous accreditation shall be verified and authorized by the LEMSA every two (2) years in a period that coincides with the paramedic’s California paramedic licensure.
General information

2023 EMS Policies

Introduction

This page includes the policies, procedures, and treatment protocols for the San Mateo County prehospital care system. The information is provided by the San Mateo County Emergency Medical Services Agency, and is designed for use within San Mateo County. Updates and new policies are noted with the implementation date. Numeric gaps in document numbers indicate that a policy or procedure has been deleted and is not part of the current San Mateo County prehospital care system.

ny questions and feedback regarding should be directed to the EMS Agency through the Field Feedback Form for immediate review and response. 

100–STANDARDS: DEFINITIONS AND ABBREVIATIONS

101 - Approved Definitions
102 - Approved Abbreviations

200–EMS SYSTEM

201 - Mission, Values and Vision
202 - Applications Standards Criteria and Review Mechanisms for Advanced Life Support Providers
203 - Emergency Medical Dispatch Program
204 - Committees
205 - Emergency Ambulance and First Response Unit Standards
206 - EMS Policy and Protocol Updates
207 - Ambulance Response and Transport Restrictions
208 - SFO Paramedic Program
209 - Mobile Stroke Unit Program

300–PERSONNEL AND PROGRAM STANDARDS

301 - EMT Certification
302 - Paramedic Accreditation
303 - Emergency Medical Dispatcher Authorization
305 - Public Safety Automatic External Defibrillation Program
306 - BLS Agency and Public Safety Optional Skills
307 - Prehospital Continuing Education Provider
308 - Emergency Medical Technician Training Program

400–COMMUNICATIONS

401 - EMS Radio Communications System
402 - EMS Radio Operations
403 - Prehospital Personnel Safety
404 - Base Hospital Communications
405 - Base Hospital and Receiving Center Reports
406 - Central Patient Routing

500–OPERATIONS

501 - Equipment Required At Scene
502 - Authority At Scene
503 - Physician at Scene
504 - Cancelling or Downgrading an EMS Response
505 - Patient Destination Determination
506 - EMS Supervisor Role
507 - Determining Death
508 - Search for Donor Card
509 - Utilization of EMS Aircraft
510 - Intercounty Emergency Responses
511 - Special Response Areas
512 - Safely Surrendered Baby Program
513 - Law Enforcement Requesting an EMS Response
514 - Patient Extrication in Limited Access Areas
515 - Reporting of Suspected Abuse
516 - Fireline Paramedics
517 - Tactical Emergency Medical Support Team
518 - Confidentiality of Patient Information
519 - Receiving Hospitals
520 - Management of Controlled Substances
521 - Refusal of Emergency Medical Care or Transport
522 - Stroke Triage and Destination
523 - EMS Event Reporting
524 - EMS System Issue Resolution
525 - Patient Restraint
526 - Multi-Casualty Incidents
528 - ALS to BLS Downgrade

600–FACILITIES

601 - Base Hospital Standards and Designation
602 - Ambulance Diversion
603 - Hospital Emergent Interfacility Transfers
604 - Trauma Center Standards
605 - STEMI Receiving Center Standards and Designation

700–DATA COLLECTIONS AND SYSTEM EVALUATION

701 - Documentation Standards
702 - Transmission of Cardiac Monitor Data
703 - EMS Data Collection and Reporting

800–EMERGENCY MEDICAL DISPATCH

900–REFERENCES 

901 - Multicasualty Incident Plan
902 - STEMI Data Dictionary
903 - Paramedic Accreditation Evaluation Form
904 - Controlled Substance Administration and Restock Form
905 - Emergency Medical Care Committee Bylaws
906 - Medical Advisory Committee Bylaws

General information

EMS Field Treatment Guidelines

Introduction

The use or possession of the protocol book does not exempt field personnel from the responsibility to know the information in the San Mateo County Policy and Procedures Manual. This protocol book does not replace the Policy and Procedures Manual and is provided as a tool for their reference.

Routine Medical Care

A group of standard assessments and treatments, including but not limited to airway, breathing and circulation, and the use of routine monitoring devices. See Routine Medical Care (G01) under General Care.

Care Outside of Protocol Guidelines

No set of protocols can cover all patient problems. We encourage the use of Base Physician contact in such events.

Universal Precautions

Disease agents may be present in any body substance or fluid, and the presence of disease agents may or may not be known. Clinically healthy individuals may carry and be capable of transmitting these agents. Precautions with all patients shall include routine use of appropriate barrier precautions to prevent skin and mucous-membrane exposure when contact with blood or other body fluids is anticipated. Refer to Routine Medical Care (G01) for more information. 

Prehospital personnel who are exposed to potentially infectious materials should immediately follow the reporting procedures set up by their agency. 

Hospital emergency departments have specific requirements for managing exposure to body substances experienced by prehospital care personnel. Emergency departments are expected to actively assist prehospital personnel in evaluating risk and recommending and/or providing appropriate prophylactic care when needed. Emergency responders are expected to identify the source patient to the hospital, and to comply with emergency department procedures (e.g. Royce log) when reporting potential exposure to infectious materials.

Prophylactic care recommendations for health care workers are found in the CDC May 23, 2018 updated U.S. Public Health Service guidelines for the Management of Occupational Exposures to HIV and Recommendation for Post Exposure Prophylaxis. Emergency departments are expected to follow these guidelines when managing prehospital exposure to potentially infectious substances.

Treatment Guidelines

RF03 - Approved Abbreviations
Treatment Protocols Index

Section 1 – General Treatment Protocols

G00 - Guide to Protocol Utilization
G01 - Routine Medical Care
G02 - End of Life
G03 - Ventricular Assist Devices
G04 - MCI Triage
G05 - Law Enforcement - Suspected Opioid Overdose

Section 2 – Adult Cardiac Arrest – Non-traumatic Treatment Protocols

CA01 - Cardiac Arrest - Non-traumatic
CA02 - Asystole and PEA
CA03 - V-Fib and Pulseless V-Tach
CA04 - Post Resuscitation
CA05 - Obvious Death

Section 3 – Adult Cardiac Dysrhthmia Treatment Protocols

CD 01 - Bradycardia (Symptomatic)
CD02 - Narrow Complex Tachycardia
CD03 - Wide Complex Tachycardia

Section 4 – Adult Respiratory Distress Treatment Protocols

A03 - Anaphylaxis
R01 - Airway Obstruction and Choking
R02 - Respiratory Arrest and Respiratory Failure
R03 - Respiratory Distress and Bronchospasm
R04 - Respiratory Distress and CHF and Pulmonary Edema
R05 - Respiratory Distress Other
R06 - Inhalation Injury
R07 - Smoke Inhalation Injury
R08 - Cold and Flu Symptoms
R09 - Submersion and Drowning
R10 - Carbon Monoxide and Cyanide

Section 5 – Adult Environment Treatment Protocols

E01 - Electrocution
E02 - Hyperthermia
E03 - Hypothermia and Cold Injury
E04 - Stings and Venomous Bites

Section 6 – Adult Toxic Exposure Treatment Protocols

X01 - Hazmat Exposure and Skin Exposure
X02 - Alcohol Intoxication
X03 - Overdose and Poisoning and Ingestion
X04 - Dystonic Reaction
X05 - Hyperactive Delirium

Section 7 – Adult Behavioral Treatment Protocols

B01 - Behaviorial and Psychiatric Crisis

Section 8 – Adult Medical Treatment Protocols

A01 - Abdominal Pain and Problems (GI and GU)
A02 - Allergic Reaction
A03 - Anaphylaxis
A04 - Altered Level of Consciousness (ALOC)
A05 - Chest Pain - Not Cardiac
A06 - Chest Pain - STEMI
A07 - Chest Pain - Suspected Cardiac
A08 - Childbirth (Mother)
A09 - Diarrhea
A10 - Dizziness and Vertigo
A11 - ENT and Dental Problem (Unspecified)
A12 - Epistaxis
A13 - Eye Problem (Unspecified)
A14 - Fever
A15 - General Weakness
A16 - Genitourinary Disorder (Unspecified)
A17 - Hyperglycemia
A18 - Hypoglycemia
A19 - Hypertension
A20 - Hypotension
A21 - Lower GI Bleeding
A22 - Nausea and Vomiting
A23 - No Medical Complaint
A24 - Non-Traumatic Body Pain
A25 - Non-Traumatic Extremity Pain and Swelling
A26 - Non-Traumatic Headache
A27 - Palpitations
A28 - Pregnancy Complication
A29 - Pregnancy and Labor
A30 - Seizure - Active
A31 - Seizure - Post
A32 - Sepsis
A33 - Shock
A34 - Stroke/CVA/TIA
A34T - Stroke/CVA/TIA - Mobile Stroke Unit (CT-1)
A35 - Syncope and Near Syncope
A36 - Upper GI Bleeding
A37 - Vaginal Bleeding
A38 - Opioid Withdrawal

Section 9 – Pediatric Cardiac Arrest Treatment Protocols 

PC01 - Cardiac Arrest
PC02 - Aystole and PEA
PC03 - V-Fib and Pulseless V-Tach
PC04 - Post Resuscitation
PC05 - Obvious Death

Section 10 – Pediatric Cardiac Dysrhythmia Treatment Protocols 

PD01 - Bradycardia
PD02 - Tachycardia (Stable)
PC03 - Tachycardia (Unstable)

Section 11 – Pediatric Treatment Protocols – Respiratory 

P03 - Anaphylaxis
PR01 - Airway Obstruction/Choking
PR02 - Respiratory Arrest/Respiratory Failure
PR03 - Respiratory Distress - Bronchospasm
PR04 - Respiratory Distress - CHF/Pulmonary Edema
PR05 - Respiratory Distress - Other
PR06 - Inhalation Injury
PR07 - Smoke Inhalation
PR08 - Cold/Flu Symptoms
PR09 - Submersion/Drowning
PR10 - Carbon Monoxide

Section 12 – Pediatric Treatment Protocols – Environmental 

PE01 - Electrocution
PE02 - Hyperthermia
PE03 - Hypothermia/Cold Injury
PE04 - Stings/Envonomations

Section 13 – Pediatric Treatment Protocols – Toxic Exposure 

PX01 - Hazmat Exposure/Skin Exposure
PX02 - Alcohol Inxotication
PX03 - Overdose/Poisoning/Ingestion
PX04 - Dystonic Reaction
PX05 - Agitated Delirium

Section 14 - Pediatric Treatment Protocols – Behavioral 

PB01 - Behavioral/Psychiatric Crisis

Section 15 - Pediatric Treatment Protocols – Medical 

P01 - Abdominal Pain/Problems (GI/GU)
P02 - Allergic Reaction
P03 - Anaphylaxis
P04 - ALOC - (Not Hypoglycemia or Seizure)
P05 - Brief Resolved Unexplained Event (BRUE)
P06 - Chest Pain - Not Cardiac
P07 - Diarrhea
P08 - Dizziness/Vertigo
P09 - ENT/Dental Problem - Unspecified
P10 - Epistaxis
P11 - Eye Problem - Unspecified
P12 - Fever
P13 - Pediatric General Weakness
P14 - Genitourinary Disorder, Unspecified
P15 - Hyperglycemia
P16 - Hypoglycemia
P17 - Hypertension
P18 - Hypotension
P19 - Lower GI Bleeding
P20 - Nausea/Vomiting
P21 - No Medical Complaint
P22 - Non-traumatic - Body Pain
P23 - Non-traumatic - Extremity Pain/Swelling
P24 - Non-traumatic - Headache
P25 - Palpitations
P26 - Seizure - Active
P27 - Seizure - Post
P28 - Pediatric Shock
P29 - Stroke/CVA/TIA
P30 - Syncope/Near Syncope
P31 - Upper GI Bleeding
P32 - Vaginal Bleeding
P33 - Newly Born

Section 16 – Trauma Treatment Protocols

T01 - Trauma Triage
T02 - Extremity Trauma
T03 - Head Trauma
T04 - Multi-System Trauma
T05 - Traumatic Arrest
T06 - Burns

Section 17 – Field Procedures

FP01 - 12-Lead ECG
FP02 - Airway BLS Management
FP03 - Airway Bougie Device
FP04 - Airway: BVM with In-Line Nebulizer
FP05 - Airway Direct Laryngoscopy Intubation
FP06 - Airway Foreign Body Removal
FP07 - Airway King Airway
F08 - Airway Stomal Intubation
FP09 - Airway Tracheostomy Tube Replacement
FP10 - Airway Video Laryngoscopy Intubation
FP11 - Childbirth
FP12 - CPAP
FP13 - End Tital CO2 (EtCO2) Monitoring
FP14 - External Pacing
FP15 - Eye Irrigation
FP16 - Helmet Removal
FP17 - In-Line Nebulizer for Flowsafe II CPAP Device
FP18 - Intraosseous Access
FP19 - Mechanical Compression Device
FP20 - Needle Decompression
FP21 - Pediatric Assessment
FP22 - Spinal Injury Assessment
FP23 - Spinal Motion Restriction
FP24 - Tourniquet
FP25 - Valsalva (Modified) Maneuver
FP26 - Vascular Access
FP27 - Wound Packing - Hemostatic Gauze
FP28 - Intramuscular (IM) Injection
FP29 - High Performance CPR

Section 18 - Reference/Drug Lists

RF01 - Pediatric Dosing Guide
RF02 - Adult Dosing Guide
RF03 - Approved Abbreviations

Epidemic/Pandemic Protocols

EP01 - Assess and Refer

Mobile App

Field Feedback Form

Field providers: use the form below to submit policy, procedure and/or protocol feedback.

Click here to open the form in a separate browser window. 

 

 

    General information

    General Information

    San Mateo County began its paramedic emergency ambulance service program almost 30 years ago. One city, South San Francisco, became a paramedic provider in 1975. In 1976, San Mateo County became the first California county to conduct a Request for Proposal (RFP) process granting an exclusive operating area for emergency ambulance service. Over the next two years a countywide system of paramedic-staffed ambulances was established.

    General information

    Maddy Fund

    Important Update: A portion of the money we normally receive for physician reimbursement through the Maddy Fund, the Emergency Medical Services Appropriation (EMSA) Funding, has been cut.  Please note that we are still administering the Maddy Fund.  Beginning July 1, in the fiscal year 2009-2010, all EMSA funding normally provided to local EMS agencies (LEMSA) is to be cut by the State of California.