Public Health

CCEMSA Policies and Procedures

Our Location: 1221 Fulton Street, 5th Floor
PO Box 11867 Fresno, CA 93775-1867
Phone: (559) 600-3387 Fax: (559) 600-7691
Email: ccemsa@fresnocountyca.gov

Hours of Operation: Monday - Friday 8:00 am - 4:00 pm

Please send any comments or questions regarding the Policy and Procedures to CCEMSA

Special Memorandums

Draft Policies

General

Dispatcher Certification/Recertification Checklist
EMT Certification/Recertification Checklist
MICN Certification/Recertification Checklist
Paramedic Accreditation/Reaccreditation Checklist
Drug Box Review
Final Approved Abbreviations List

001-099 Administration

001 Table of Contents
011 EMS Policy Implementation
020 Medical Control
021 Medical Control Committee
022 Regional Hospital Advisory Committee

100-199 Personnel Policies

110 Prehospital Personnel: License Accreditation and Certification Review Process
111 EMT Training Program Approval
111.2 Public Safety First Aid Training Programs
112 EMT Certification
113 EMT Challenge Certification
114 EMT Recertification
115 EMT Record Keeping and Fees
119 Scope of Practice for EMT
119.2 Scope of Practice for Public Safety First Aid Personnel
122 Advanced EMT (AEMT) Certification
124 Advanced-EMT (AEMT) Recertification
129 Scope of Practice for Advanced EMT (AEMT)
131 Paramedic Training Program Approval
133 Paramedic Accreditation
134 Paramedic Continued Accreditation/Continuing Education
136 Critical Care Paramedic Accreditation
137 Critical Care Paramedic Continued Accreditation
139 Paramedic Scope of Practice
141 MICN Training Program Approval
142 MICN Certification
144 MICN Recertification/Continuing Education
151 Base Hospital Physician Training Program Approval
152 Base Hospital Physician Certification
153 Base Hospital Physician Recertification
162 EMS Dispatcher Certification
164 EMS Dispatcher Recertification
168 EMS Dispatcher - Continuing Education Requirements

200-299 EMS Prehospital Providers

200 Authorization of Ambulance Provider Agencies in Fresno County
201 Authorization of Ambulance Provider Agencies in Kings County
202 Authorization of Ambulance Provider Agencies in Madera County
203 Authorization of Ambulance Provider Agencies in Tulare County
205 Fresno County Rural Ambulance Contractor Reimbursement Program
205 Attachment A - Auditor-Controller Uncollectible Accounts Form
205 Attachment B - Fresno County EMS Uncollectibles Request Form
210 Ambulance Ordinance Licensure Implementation
211.1 First Responder/EMT AED Service Provider
212 Administration of Naloxone by Law Enforcement/First Responders
241 Approval of Paramedic Provider Agencies
242 Approval of Critical Care Paramedic Provider Agencies
243 Fireline and Urban Search and Rescue Paramedic Response
244 EMS Training Officer
245 Paramedic Triage to Alternate Destination Program
251 Prehospital Liaison Officer
261 Special Rescue Team
291 Equipment Standards - EMS Units
293 Drug and Solution Standards

300-399 Facilities

311 Base Hospital Criteria
311 AED Base Hospital
312 Base Hospital Medical Director
312.1 AED Medical Director
313 Prehospital Liaison Nurse
314 Receiving Hospital Liaison Nurse
320 STEMI Critical Care System Overview
321 STEMI Receiving Center and STEMI Referring Hospital Standards
322 STEMI Receiving Center and STEMI Referring Hospital Designation
323 STEMI Critical Care System Monitoring/Data Management
330 Trauma System Overview
331 Trauma Facility Designation
332 Trauma System Monitoring
333 Trauma Center Criteria
334 Trauma Registry Data Collection
340 Impact Evaluation of Reduction or Closure of Hospital Emergency Services
341 Scope of Practice During Interfacility Transports
342 Guidelines for Transfer Agreements Between Acute Care Hospitals
351 Pediatric Critical Care Center Designator
352 Pediatric Critical Care Center Criteria
353 Pediatric Staffing and Equipment Guidelines for Emergency Departments
360 Stroke Critical Care System Overview
361 Stroke Center Standards
362 Stroke Center Designation
363 Stroke Critical Care System Monitoring/Data Management

400-499 Communications

400 EMS Communications System Overview
401 EMS Dispatch Center Requirements
402 Management of Medical 9-1-1 Calls in Fresno County
403 Incident Notification
405 EMS Dispatch Policy
406 Suspension of Priority 3 - Non-Emergency Medical Ambulance Responses
407 First Responder Unit Transports
408 Helicopter Dispatch
410 Request for Search and Rescue Operations
411 STAR Rescue Team Dispatch
412 On-Scene Security (Holdbacks)
415 StatusNet911

510 BLS Protocols

510 Basic Life Support (BLS) Protocols
510.01 Table of Contents
510.02 Basic Life Support Call-Ins
510.03 Prehospital Rendezvous
510.04 Prehospital Use of Oxygen
510.05 Tracheostomy Care/Suctioning
510.06 Spinal Immobilization
510.07 Monitoring IVs
510.08 Cardiac Arrest - Medical
510.09 Cardiac Arrest - Trauma
510.10 Chest Pain
510.11 Respiratory Distress
510.12 Airway Obstruction
510.13 Altered Level of Consciousness
510.14 Syncope (Any Transient Loss of Consciousness)
510.15 Seizures
510.16 Stroke
510.17 Ingestion/Poisoning
510.18 Abdominal Emergencies (Medical and Trauma)
510.19 Shock (Hypotension)
510.20 Head Trauma
510.21 Chest Trauma
510.22 Orthopedic Trauma
510.23 Soft Tissue Injuries
510.24 Ear Injuries
510.25 Eye Injuries
510.26 Burns
510.27 Hyperthermia
510.28 Hypothermia
510.29 Frostbite
510.30 Near-Drowning
510.31 Snakebite
510.32 Stings/Bites (Allergic Reactions and Anaphylactic Shock)
510.33 Childbirth
510.34 Behavioral Emergencies

530 Paramedic Protocols

530 Paramedic Treatment Protocols
530.01 Table of Contents
530.02 General Procedures
530.03 Cardiac Arrest - Medical
530.04 Cardiac Arrest - Trauma
530.05 Dysrhythmias
530.06 Ventricular Fibrillation - Pulseless Ventricular Tachycardia
530.07 Ventricular Tachycardia with Pulses
530.08 Asystole
530.09 Pulseless Electrical Activity
530.10 Bradydysrhythmias - Ventricular Rate Less Than 60
530.11 Paroxysmal Supraventricular Tachycardia
530.12 Atrial Fibrillation
530.13 Coronary Ischemic Chest Discomfort
530.14 Shortness of Breath with Bronchospasm (Including COPD and Asthma)
530.15 Shortness of Breath with Pulmonary Edema (Including CHF)
530.16 Respiratory Distress
530.17 Airway Obstruction - Foreign Body
530.18 Altered Mental Status and Syncope
530.19 Seizures
530.20 Ingestion/Poisoning
530.21 Shock (Non-Traumatic)
530.22 Allergic Reactions and Anaphylactic Shock
530.23 Trauma
530.24 Burns
530.25 Near-Drowning
530.26 Snakebite
530.27 Behavioral Emergencies
530.28 Dystonic Reactions to Phenothiazine Drugs
530.29 Vaginal Bleeding
530.30 Childbirth
530.31 Neonatal Resuscitation (Patients less than 24 Hours of Age)
530.32 Pediatric Primary Survey
530.33 Pediatric Ventricular Fibrillation - Pulseless Ventricular Tachycardia
530.34 Pediatric Asystole
530.35 Pediatric Pulseless Electrical Activity
530.36 Pediatric Bradycardia
530.37 Pediatric Tachycardia with Pulses
530.38 Pediatric Respiratory Distress (Epiglottitis, Asthma, Bronchiolitis, Croup)
530.39 Pediatric Shock (Non-Traumatic)
530.40 Suspected Stroke
530.41 Nausea and/or Vomiting
530.42 Adult Pain Management
530.43 Pediatric Pain Management
Drug Box Review

540 Critical Care Paramedic Protocols

540 Critical Care Paramedic Treatment Protocols
540.01 Table of Contents
540.02 General Procedures
540.03 Amiodarone Hydrochloride Infusion
540.04 Blood/Blood Product Infusion
540.05 Glycoprotein IIb/IIIa Receptor Inhibitors Infusion
540.06 Heparin Infusion
540.07 Lidocaine Infusion
540.08 Midazolam Infusion for Intubated Patients
540.09 Morphine Sulfate Infusion
540.10 Nitroglycerin Infusion
540.11 Potassium Chloride Infusion
540.12 Sedation for Ventilator/Agitated Patients
540.13 Sodium Bicarbonate Infusion
540.14 Thoracostomy Tubes
540.15 Total Parenteral Nutrition
540.16 Ventilators (Automatic Transport) - ATV
540.17 Norephinephrine Infusion
540.18 Magnesium Sulfate Infusion
540.19 Fentanyl Infusion (Sublimaze)
540.20 Dopamine Hydrochloride Infusion
540.21 Calcium Channel Blocker Infusion

541-599 Operations

541 Identification of EMS Personnel
542 Prehospital Division of Responsibility
543 Turnover Responsibilities Between Prehospital Units
544 Criteria for Receiving and Base Hospital Contact
544 Adult RMCT Patient (18-years and older) Refusal of Care and Transportation Screening Form
544 Minor RMCT Patient (under 18 years old) Refusal of Care and Transportation Screening Form
545 Reporting ALS Without Base Hospital Contact
546 Refusal of Emergency Care and Transportation
546 Risks of Refusal of Care or Transport Form
547 Patient Destination
547.1 Hospital Diversion of Ambulance Patients
548 Code 3 Transport
549 Initiation/Termination of CPR in the Medical Patient
550 Initiation/Termination of CPR in the Trauma Patient
551 Conduct at the Scene of a Deceased Person
552 Out of County Transports
553 ALS Interfacility Transports
554 Non-Acute Care Facility or Physician's Office to Hospital Transport
555 Physician at the Scene Medical Direction
556 Exposure to Blood and/or Body Fluids
560 Blood Pressure Testing by EMS Personnel
561 Emergency Equipment at the Scene
562 Patient Transports from Multiple Incident Sites
564 Guidelines for Do Not Resuscitate
565 Maintenance of Patient Controlled Therapy
566 Use of Pre-Hospital Hotline Numbers - Base Hospitals
567 Delivering Patients to Receiving Hospitals
568 Nerve Agent Exposure
570 Emergency Medical Services Abuse Policy
571 Assess and Refer

600-699 Disaster

600 Multi-Casualty Incident Response Overview and Summary
610 Multi-Casualty Incident Management - Dispatch Operations
620 Multi-Casualty Incident Management - Prehospital Operations
630 Multi-Casualty Incident Management - Base Hospital/Disaster Control Facility Operations
640 EMS Agency Staff Responsibilities
690 Hazardous Materials Incident
690.1 Clinical Management of Patients Exposed to Hazardous Materials

700-899 Local EMS Agency

702 Continuing Education Providers
703 Continuous Quality Improvement
704 Quality Improvement Reporting
704 Quality Improvement Report Form
704 Quality Improvement Tracking Form
811 Prehospital Care Report
812 First Responder Prehospital Care Report - BLS - UNDER REVISON