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EMS Patient Treatment Protocols

General information


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

Treatment Protocol Index
General Treatment Protocols
G00 - Guide to Protocol Utilization
G01 - Routine Medical Care
G02 - End of Life Care
G03 - Ventricular Assist Devices
G04 - MCI Triage
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
Adult Cardiac Dysrhthmia Treatment Protocols
CD01 - Symptomatic Bradycardia
CD02 - Narrow Complex Tachycardia
CD03 - Wide Complex Tachycardia
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
Adult Environment Treatment Protocols
E01 - Electrocution
E02 - Hyperthermia
E03 - Hypothermia and Cold Injury
E04 - Stings and Venomous Bites
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
Adult Behavioral Treatment Protocols
B01 - Behaviorial and Psychiatric Crisis
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
Trauma Evaluation and Management

Reference/Drug Lists

Adult Drug Card Rev 9/2019
Pediatric Drug Card Rev 8/2019

Field Feedback Form

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

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