Emergency Medical Services

EMS Blue Line

All-Hazard Health Services Capacity Management Plan - LEVEL 3 Partial Activation

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System Stress Tool Tool Status Effective Date End Date  Notes
Health Services Capacity Task Force Plan Level Staffing Augmentation ACTIVE Per MOA/ contract -- County-contracted Ambulance Operational Areas with Health Services Capacity Task Force Plan Level staffing augmentation should contact their County Contracting Officer’s Representative (COR)
9-1-1 Response Mode Alteration AVAILABLE May 27, 2022 July 31, 2022 P-801 waiver authorizations allow agencies without approved alternate dispatch plans to send one paramedic to calls for service when necessary. Agency reporting to the LEMSA REQUIRED.
Assess and Refer Option AVAILABLE May 27, 2022 September 1, 2022 The use of the Assess and Refer policy REQUIRES agency reporting to the LEMSA 
4:1 Paramedic to Patient ratio at EDs  ACTIVE  -- -- LEMSA-allowed procedure and available when necessary
EMS Transfer to Waiting Area Option ACTIVE December 30, 2020 Until further notice  
Patient Masking Recommendation ACTIVE April 3, 2020

Until further notice

To reduce the risk of viral spread, and in compliance with current CDPH regulations, EMS providers are reminded that masks must be worn in all healthcare settings
DoD Beneficiary Destination Recommendation ACTIVE September 15, 2022 Until further notice  
EMS Treatment Considerations ACTIVE March 11, 2020 Until further notice  
Abbreviated Radio Report Option ACTIVE

December 28, 2020

Until further notice  
Non-Patient Passenger Restrictions ACTIVE March 12, 2020 Until further notice  
Ambulance Strike Team AVAILABLE -- -- Agencies/Hospitals may request ASTs (or other resources) through the MHOAC at their expense

2022 - 2023 Protocol Updates

2022-2023 protocol update graphic for web

2022 - 2023 protocol packet available now.

All changes take effect July 1, 2022.

Please see the protocol change log for updates.


Guidance regarding Human Monkeypox

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County EMS needs your feedback!


The San Diego County EMS Office is conducting a 5-year strategic planning process. Part of this plan development includes gathering input from the EMS community.


If you are an EMT, AEMT, Paramedic, MICN, or other EMS provider, please take 3 minutes to complete this survey.


County EMS Procurements

EMS Solicitations Name and Commodity Code(s)

RFP 11597


Comprehensive Evaluation of Base Hospital System and Trauma Catchment

80100000, 80101504 and 85100000

RFP 10978 

CSA-17 Paramedic Service Level Ambulance Services 


Please check BuyNet for updates via Addendum 1, posted 6/10/2022, Addendum 2, posted 6/24/2022.

Interested parties must register in BuyNet and select appropriate commodity codes in order to receive updates.   BuyNet registration instructions.

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Medication shortage information

The San Diego County EMS Office is aware that normal saline, epinephrine 1:10,000 1 mg/10 mL (0.1 mg/mL) pre-filled syringes, and injectable dextrose 50% vials are in limited supply and may be difficult to obtain.

Please see the EMS Medical Director's communications regarding these shortages:

Normal saline-related guidance  
April 20, 2022  
Epinephrine-related guidance  
April 7, 2022
Use of expired medications
April 7, 2022
New option for push-dose epinephrine preparation
March 29, 2022 Mitigation strategies  
February 28, 2022   Cardiac and push-dose epinephrine guidance   
Dextrose-related guidance  
February 28, 2022    


Notify County EMS via EMSNotifications@sdcounty.ca.gov when medication or supply shortages resolve. 


COVID-19 information for EMS professionals

COVID-19 Information for EMS



More information from County EMS, including links to policy updates and guidance for EMS professionals, are posted on this page.


Behavioral health program for first responders

Ryna Mitchell First Responder Behavioral Health Support Program logo

The Fire Captain Ryan Mitchell behavioral health support program is a free, confidential 24/7 peer-supported referral hotline.

This program aims to increase awareness about local mental health resources and decrease the stigma and barriers associated with First Responders seeking behavioral health support services.

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The County of San Diego EMS, with the cooperation of local EMS partners, has implemented a new electronic, cloud-based data program, called the CoSD Local EMS Information System (CoSD LEMSIS):

  • All prehospital personnel credentialing is now online through the LEMSIS Licensing Portal
  • For more information on the whole system, click HERE
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EMS Reference Materials

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County EMS Grantville offices have officially moved! 

All County EMS Staff are working remotely. There are NO in-person services available. Please call 619-285-6429 or email us with any questions.


Here is our new mailing address:

San Diego County EMS Office (MS O-202)
5560 Overland Avenue, Suite 400
San Diego, CA 92123