EMS Providers
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:
- Be eighteen (18) years of age or older.
- Provide a current government-issued photo ID (e.g., state driver’s license, state ID card, military ID card, passport).
- 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.
- 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:
- Possess a valid and current California EMT certificate.
- Complete a minimum of twenty-four (24) hours of approved
prehospital continuing education within the two (2) year
certification period.
- Continuing Education hours must be from one of the
following:
- an approved Commission on Accreditation For Pre-Hospital Continuing Education (CAPCE) provider
- an approved California Prehospital Continuing Education Provider
- college courses in physical, social or behavioral sciences (e.g., anatomy, physiology, sociology, psychology) – copy of official transcript required
- Continuing Education hours must be from one of the
following:
- 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:
- 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:
- Possess a California EMT certificate that is expired for more than twelve (12) months, but less than twenty-four (24) months.
- Complete a minimum of forty-eight (48) hours of approved prehospital continuing education within the prior two (2) year period.
- Successfully complete the National Registry of Emergency Medical Technicians (NREMT) written and skills exam within the past two (2) years.
- 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:
- Possess a current California paramedic license.
- 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
- 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.
- 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;
- 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.
2025 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.
Any questions and feedback regarding should be directed to the EMS Agency through the Field Feedback Form for immediate review and response.
Index
100 - EMS Policy Index |
100–STANDARDS: DEFINITIONS AND ABBREVIATIONS
101 - Approved Definitions |
102 - Approved Abbreviations |
200–EMS SYSTEM
300–PERSONNEL AND PROGRAM STANDARDS
400–COMMUNICATIONS
500–OPERATIONS
600–FACILITIES
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
2025 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
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 - Behavioral and Psychiatric Crisis |
Section 8 – Adult Medical Treatment Protocols
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) |
PD03 - Tachycardia (Unstable) |
Section 11 – Pediatric Treatment Protocols – Respiratory
Section 12 – Pediatric Treatment Protocols – Environmental
PE01 - Electrocution |
PE02 - Hyperthermia |
PE03 - Hypothermia/Cold Injury |
PE04 - Pediatric Stings/Venomous Bites |
Section 13 – Pediatric Treatment Protocols – Toxic Exposure
PX01 - Hazmat Exposure/Skin Exposure |
PX02 - Alcohol Intoxication |
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
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
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.
Memos and Communications
The following memos and communications come from the San Mateo County EMS Agency and EMS Medical Director. The following documents enhance and support current policy, procedures, and protocols. All posted content should be considered current policy.
- Healthcare Facilities - Required Notification on Reportable Infectious Disease to Prehospital Personnel
- Base Hospital Designation – Stanford Hospital (21–CLN–04)
- Online Licensing Portal and Application Process (21–BUL–01)
- COVID-19 Guidance Rescinded (21–CLN–06)
- COVID and Seasonal Influenza Vaccination and Swab Testing (21-BUL-02 )
- Central Patient Routing (21–OPS–01)
- 9-1-1 System Basic Life Support (BLS) Ambulance Response and Transpor
- Transfer of Patient Care at Receiving Hospitals (21–CLN–01)
- Assess and Refer and Hospital Transfer (22–CLN–01)
- 22-OPS-02 - COVID Metric Reporting Rescinded
- 22-CLN-04 - Use of Expired Medications and Supplies Not Authorized.pdf
- 22-CLN-05 - Recommendations for use of N-95 and surgical masks
- 23-CLN-01 Seton Hospital Ability to Receive 12-lead ECGs.pdf
- 23–OPS–02 Prehospital Trauma Life Support (PHTLS) Requirement
- Seton Coastside Temporary Closure (24–BUL–04)
- Seton Medical Center STEMI Diversion (24–BUL–02)
- Ambulance Patient Offload Time (APOT) Standard
- Seton Medical Center STEMI Diversion (24–BUL–01)
- Seton Medical Center STEMI Diversion (24–BUL–03)
- Seton Medical Center – Primary Stroke Center Closure (23–OPS–01)
- 24-OPS-01 - UCSF St. Francis Burn Center
- Read more
EMERGENCY PREPAREDNESS
Learn how to be ready for an emergency or natural disaster
- Be Earthquake Safe
- Flood Resources
- Terrorism Preparedness
- Emergency Volunteer Opportunities
- Pet Emergency Preparedness
EMS PLANS & REPORTS
System Overviews
EMS Plans & Reports
- 2020-22 San Mateo County EMS and Specialty Care Plans
- 2019-20 - San Mateo County STEMI Critical Care System Plan
- 2019-20 - San Mateo County Stroke Critical Care System Plan
- 2019 - San Mateo County EMS Plan
- 2018 - San Mateo County EMS Plan Update
- 2017 - San Mateo County EMS Plan
- 2020 - EMS QI Plan
- 2019 - EMS QI Plan
- 2018 - EMS QI Plan
- 2020 EMS Trauma System Status Report
- 2017-18 EMS Trauma System Status Report
- 2016-17 EMS Trauma System Status Report
Public Access Defibrillation
Regulation Update for AED
On September 3, 2015 SB 658 was signed into law, reducing liability conditions on a person or entities that acquire and place an AED. As a result, Chapter 1.8, Div. 9, Title of 22 of the California Code of Regulations is now repealed.
- Health Club Automatic External Defibrillation (AED) Use Report (NEW - 2/2015)
- Law Enforcement Automatic External Defibrillation (AED) Use Report (NEW - 2/2015)
- Public Access Automatic External Defibrillation (AED) Use Report (NEW - 2/2015)
- Public Safety Provider Agency Automatic External Defibrillation (AED) Use Report (NEW - 2/2015)
- PAD Notification Form
- CA EMS Authority - Regulation Repeal Memo
- AED User/Site Coor. Checklist
- Read more
- Senate Bill No. 658, Automated External Defibrillators
- Law 360: The ABCs Of Calif.'s Automated External Defibrillator Law
- OSHA Review: AED Requirements in California – Regulations
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.
EMS Field & Optional Scope Training
- Communications with SMC Sheriff's Office Re: Naloxone
- SMC EMS Policy - Personnel 6 - Public Safety First Aid & Optional Scope
- Menlo Park PD Narcan Deployment Policy
- San Mateo County LE Naloxone Training
- Naloxone Skills Sheet
- San Mateo County Naloxone Admin Training Test
San Mateo County LE – Naloxone Administration Reporting (refer to the ‘Forms’ section of the SMC EMS mobile phone app).
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.
EMS Contracts & Amendments
Ambulance Contracts & Amendments
- ALS Ambulance Transport Agreement, 2019-2029 (Effective 7/1/2019)
- ALS Ambulance Transport Agreement, Amendment 1, 2013-2019
- ALS Ambulance Transport Agreement, 2009-2013
- 2003 Grand Jury Report on EMS System
Fire / First Responders Contracts & Amendments
- Agreement with San Francisco Airport Commission for Designated Paramedic Service at SFO
- ALS Fire First Response Agreement, 2019-2029 (Effective 7/1/2019)
- 2009 Fire First Reponse Contract
- Fire Services / AMR Operating Agreement