EMS Providers

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.

Bibliography of Standard Texts   Rev 1/2009

Pediatric Definitions  Rev 1/2009

Abbreviation List  Rev 1/2009

Treatment Protocols

Protocol Updates - 10/23/2019

Treatment Protocol Index

Section 1 – General Treatment Protocols

G00 - Guide to Protocol Utilization

G01 - Routine Medical Care

G02 - End of Life Care

G03 - Ventricular Assist Devices

G04 - MCI Triage

Trauma and Burns

Burns

Burns - Pediatric

Trauma Evaluation & Management

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

CA01 - Cardiac Arrest

CA02 - Asystole and PEA

CA03 - V-Fib and Pulseless V-Tach

CA03T - Refractory V-Tach/Pulseless V- Fib Mills-Peninsula Pilot

CA04 - Post Resuscitation

CA05 - Obvious Death

Section 3 – Adult Cardiac Dysrhthmia Treatment Protocols

CD01 - Symptomatic Bradycardia

CD02 - Narrow Complex Tachycardia

CD03 - Wide Complex Tachycardia

Section 4 – Adult Respiratory Distress Treatment Protocols

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 - Agitated 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 and CVA and TIA

A34T - Stroke and CVA and TIA - Mobile Stroke Unit (CT-1)

A35 - Syncope and Near Syncope

A36 - Upper GI Bleeding

A37 - Vaginal Bleeding

Pediatric Treatment Protocols

Allergic Reaction

Altered Mental Status

Apparent Life Threatening Events (ALTE)

Cardiac Arrest: Asystole

Cardiac Arrest: Ventricular Fibrillation/Pulseless Ventricular Tachycardia

Cardiac Arrest: Overview

Dysrhythmias: Bradycardia

Dysrhythmias: Tachycardia

Interim Pain Assessment & Management

Nausea and Vomiting

Neonatal Resuscitation

Patient Assessment/Routine Medical Care

Poisoning and Overdose

Respiratory Distress

Seizures

Shock

Reference/Drug Lists

Adult Drug Card Rev 9/2019

Pediatric Drug Card Rev 10/2019

Mobile App

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Field Feedback Form

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

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