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Field Treatment Guidelines

Emergency Medical Services

Divisions / Emergency Medical Services / 9-1-1 EMS System and Resources / EMS Field Reference / Field Treatment Guidelines

The San Mateo County EMS Field Treatment Guidelines provide clinical guidance for authorized prehospital personnel practicing within the County. They are designed as a field reference and do not replace the EMS Policy Manual; personnel remain responsible for knowing and following all applicable policies.

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Using the Guidelines

Routine Medical Care

Routine Medical Care includes the standard assessments, treatments and monitoring used throughout patient care. Refer to G01 – Routine Medical Care for the complete guidance.

Care Outside the Guidelines

No set of treatment guidelines can address every patient presentation. Contact the Base Physician when consultation is needed for care outside the established guidelines.

Universal Precautions

Use appropriate barrier precautions whenever contact with blood or other body fluids is anticipated. Personnel with a potential exposure should immediately follow their employer’s reporting process and applicable EMS policies.

Treatment Guideline Library

Expand a section to view the current treatment guidelines. Each document opens in a separate browser tab.

  Section 1 – General Treatment Protocols
Protocol Title Document
G00 Guide to Protocol Utilization Open guideline
G01 Routine Medical Care Open guideline
G02 End of Life Care Open guideline
G03 Ventricular Assist Devices Open guideline
G04 MCI Triage Open guideline
G05 Law Enforcement – Suspected Opioid Overdose Open guideline
  Section 2 – Adult Cardiac Arrest (Non-Traumatic)
Protocol Title Document
CA01 Cardiac Arrest (Non-Traumatic) Open guideline
CA02 Cardiac Arrest (Asystole and PEA) Open guideline
CA03 Cardiac Arrest (V-Fib and Pulseless V-Tach) Open guideline
CA04 Cardiac Arrest (ROSC) Open guideline
CA05 Obvious Death Open guideline
  Section 3 – Adult Cardiac Dysrhythmia
Protocol Title Document
CD01 Bradycardia (Symptomatic) Open guideline
CD02 Narrow Complex Tachycardia Open guideline
CD03 Wide Complex Tachycardia Open guideline
  Section 4 – Adult Respiratory Distress
A03 Anaphylaxis is cross-listed here; filed under Section 8
Protocol Title Document
R01 Airway Obstruction and Choking Open guideline
R02 Respiratory Arrest and Respiratory Failure Open guideline
R03 Respiratory Distress (Bronchospasm) Open guideline
R04 Respiratory Distress (CHF and Pulmonary Edema) Open guideline
R05 Respiratory Distress (Other) Open guideline
R06 Inhalation Injury Open guideline
R07 Smoke Inhalation Injury Open guideline
R08 Cold and Flu Symptoms Open guideline
R09 Submersion and Drowning Open guideline
R10 Carbon Monoxide and Cyanide Open guideline
  Section 5 – Adult Environmental
Protocol Title Document
E01 Electrocution Open guideline
E02 Hyperthermia Open guideline
E03 Hypothermia (Cold Injury) Open guideline
E04 Stings and Venomous Bites Open guideline
  Section 6 – Adult Toxic Exposure
Protocol Title Document
X01 Hazmat Exposure (Skin Exposure) Open guideline
X02 Alcohol Intoxication Open guideline
X03 Overdose and Poisoning (Ingestion) Open guideline
X04 Dystonic Reaction Open guideline
X05 Hyperactive Delirium Open guideline
  Section 7 – Adult Behavioral
Protocol Title Document
B01 Behavioral Crisis (Psychiatric) Open guideline
  Section 8 – Adult Medical
Protocol Title Document
A01 Abdominal Pain and Problems (GI and GU) Open guideline
A02 Allergic Reaction Open guideline
A03 Anaphylaxis Open guideline
A04 Altered Level of Consciousness (ALOC) Open guideline
A05 Chest Pain – Not Cardiac Open guideline
A06 Chest Pain – STEMI Open guideline
A07 Chest Pain – Suspected Cardiac Open guideline
A08 Childbirth (Mother) Open guideline
A09 Diarrhea Open guideline
A10 Dizziness and Vertigo Open guideline
A11 ENT and Dental Problem (Unspecified) Open guideline
A12 Epistaxis Open guideline
A13 Eye Problem (Unspecified) Open guideline
A14 Fever Open guideline
A15 General Weakness Open guideline
A16 Genitourinary Disorder (Unspecified) Open guideline
A17 Hyperglycemia Open guideline
A18 Hypoglycemia Open guideline
A19 Hypertension Open guideline
A20 Hypotension Open guideline
A21 Lower GI Bleeding Open guideline
A22 Nausea and Vomiting Open guideline
A23 No Medical Complaint Open guideline
A24 Non-Traumatic Body Pain Open guideline
A25 Non-Traumatic Extremity Pain and Swelling Open guideline
A26 Non-Traumatic Headache Open guideline
A27 Palpitations Open guideline
A28 Pregnancy Complications Open guideline
A29 Pregnancy (Labor) Open guideline
A30 Seizure (Active) Open guideline
A31 Seizure (Post) Open guideline
A32 Sepsis Open guideline
A33 Shock Open guideline
A34 Stroke and TIA Open guideline
A34T Stroke and TIA (Mobile Stroke Unit) Open guideline
A35 Syncope and Near Syncope Open guideline
A36 Upper GI Bleeding Open guideline
A37 Vaginal Bleeding Open guideline
A38 Opioid Withdrawal Open guideline
  Section 9 – Pediatric Cardiac Arrest
Protocol Title Document
PC01 Pediatric Cardiac Arrest Open guideline
PC02 Pediatric Cardiac Arrest (Asystole and PEA) Open guideline
PC03 Pediatric Cardiac Arrest (V-Fib and Pulseless V-Tach) Open guideline
PC04 Pediatric Cardiac Arrest (ROSC) Open guideline
PC05 Pediatric Obvious Death Open guideline
  Section 10 – Pediatric Cardiac Dysrhythmia
Protocol Title Document
PD01 Pediatric Bradycardia Open guideline
PD02 Pediatric Tachycardia (Stable) Open guideline
PD03 Pediatric Tachycardia (Unstable) Open guideline
  Section 11 – Pediatric Respiratory
P03 Anaphylaxis is cross-listed here; filed under Section 15
Protocol Title Document
PR01 Pediatric Airway Obstruction and Choking Open guideline
PR02 Pediatric Respiratory Arrest and Respiratory Failure Open guideline
PR03 Pediatric Respiratory Distress (Bronchospasm) Open guideline
PR04 Pediatric Respiratory Distress (CHF and Pulmonary Edema) Open guideline
PR05 Pediatric Respiratory Distress (Other) Open guideline
PR06 Pediatric Inhalation Injury Open guideline
PR07 Pediatric Smoke Inhalation Injury Open guideline
PR08 Pediatric Cold and Flu Symptoms Open guideline
PR09 Pediatric Submersion and Drowning Open guideline
PR10 Pediatric Carbon Monoxide and Cyanide Open guideline
  Section 12 – Pediatric Environmental
Protocol Title Document
PE01 Pediatric Electrocution Open guideline
PE02 Pediatric Hyperthermia Open guideline
PE03 Pediatric Hypothermia (Cold Injury) Open guideline
PE04 Pediatric Stings and Venomous Bites Open guideline
  Section 13 – Pediatric Toxic Exposure
Protocol Title Document
PX01 Pediatric Hazmat Exposure (Skin Exposure) Open guideline
PX02 Pediatric Alcohol Intoxication Open guideline
PX03 Pediatric Overdose and Poisoning (Ingestion) Open guideline
PX04 Pediatric Dystonic Reaction Open guideline
PX05 Pediatric Hyperactive Delirium Open guideline
  Section 14 – Pediatric Behavioral
Protocol Title Document
PB01 Pediatric Behavioral Crisis (Psychiatric) Open guideline
  Section 15 – Pediatric Medical
Protocol Title Document
P01 Abdominal Pain Open guideline
P02 Pediatric Allergic Reaction Open guideline
P03 Pediatric Anaphylaxis Open guideline
P04 Pediatric Altered Level of Consciousness Open guideline
P05 Pediatric BRUE Open guideline
P06 Pediatric Chest Pain (Not Cardiac) Open guideline
P07 Pediatric Diarrhea Open guideline
P08 Dizziness / Vertigo Open guideline
P09 ENT / Dental Problem (Unspecified) Open guideline
P10 Epistaxis Open guideline
P11 Eye Problem (Unspecified) Open guideline
P12 Fever Open guideline
P13 Pediatric General Weakness Open guideline
P14 Genitourinary Disorder (Unspecified) Open guideline
P15 Pediatric Hyperglycemia Open guideline
P16 Pediatric Hypoglycemia Open guideline
P17 Hypertension Open guideline
P18 Hypotension Open guideline
P19 Lower GI Bleeding Open guideline
P20 Pediatric Nausea and Vomiting Open guideline
P21 Pediatric No Medical Complaint Open guideline
P22 Pediatric Non-Traumatic Body Pain Open guideline
P23 Pediatric Non-Traumatic Extremity Pain (Swelling) Open guideline
P24 Non-Traumatic Headache Open guideline
P25 Pediatric Palpitations Open guideline
P26 Pediatric Seizure (Active) Open guideline
P27 Pediatric Seizure (Post) Open guideline
P28 Pediatric Shock Open guideline
P29 Pediatric Stroke and TIA Open guideline
P30 Syncope and Near Syncope Open guideline
P31 Pediatric Upper GI Bleeding Open guideline
P32 Pediatric Vaginal Bleeding Open guideline
P33 Newly Born Open guideline
  Section 16 – Trauma
Protocol Title Document
T01 Trauma Triage Open guideline
T02 Extremity Trauma Open guideline
T03 Head Trauma Open guideline
T04 Multi-System Trauma Open guideline
T05 Traumatic Arrest Open guideline
T06 Burns Open guideline
  Section 17 – Field Procedures
Protocol Title Document
FP01 12-Lead ECG Open guideline
FP02 Airway (BLS Management) Open guideline
FP03 Airway (Bougie Device) Open guideline
FP04 Airway (BVM with In-Line Nebulizer) Open guideline
FP05 Airway (Direct Laryngoscopy Intubation) Open guideline
FP06 Airway (Foreign Body Removal) Open guideline
FP07 Airway (Supraglottic Device) Open guideline
FP08 Airway (Stomal Intubation) Open guideline
FP09 Airway (Tracheostomy Tube Replacement) Open guideline
FP10 Airway (Video Laryngoscopy Intubation) Open guideline
FP11 Childbirth Open guideline
FP12 CPAP Open guideline
FP13 End Tidal CO2 Monitoring Open guideline
FP14 External Pacing Open guideline
FP15 Eye Irrigation Open guideline
FP16 Helmet Removal Open guideline
FP17 In-Line Nebulizer for CPAP Device Open guideline
FP18 Intraosseous Access Open guideline
FP19 Mechanical Compression Device Open guideline
FP20 Needle Thoracostomy Open guideline
FP21 Pediatric Assessment Open guideline
FP22 Spinal Injury Assessment Open guideline
FP23 Spinal Motion Restriction Open guideline
FP24 Tourniquet Open guideline
FP25 Valsalva Maneuver (Modified) Open guideline
FP26 Vascular Access Open guideline
FP27 Wound Packing (Hemostatic Gauze) Open guideline
FP28 Intramuscular Injection Open guideline
FP29 High-Performance CPR Open guideline
FP30 Existing Vascular Access Open guideline
FP31 Epinephrine Preparations Open guideline
  Section 18 – Reference / Drug Lists
Protocol Title Document
RF01 Pediatric Dosing Guide Open guideline
RF02 Adult Dosing Guide Open guideline
RF03 Approved Abbreviations Open guideline

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