Emergency Medical Services
All-Hazard Health Services Capacity Management Plan - Level 5 (Baseline Surveillance)
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All-Hazard Health Services Capacity Management Plan - System Stress Tools
Below are system stress tools that are used based on the All-Hazard Health Services Capacity Management Plan Level.
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Active System Stress Tools
- 4:1 Patient to EMS Professional Ratio at EDs
- 9-1-1 Response Mode Alteration
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Ambulance Strike Team
- Agencies and hospitals may request ASTs, or other resources, through the MHOAC at their expense
- EMS Transfer to ED Waiting Area Option
- Health Services Capacity Task Force Plan Level
Staffing Augmentation
- County-contracted Ambulance Operational Areas within HSCTF Plan Level staffing augmentation should contact their County Contracting Officer's Representative (COR)
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Active System Stress Tools
Latest News

Alvarado Medical Center transition to UCSD Health - Update for EMS
December 5, 2023, 1:00 PM PDT
UCSD Health has announced a change in operations at the Alvarado Medical Center Campus, affecting the EMS delivery system. Please see this announcement from UCSD for additional information.
The County of San Diego EMS Office would like to communicate several
important notes:
- Effective December 11, 2023, the Alvarado Medical Center Campus will transition to UC San Diego Health East Campus Medical Center.
- Existing specialty care services will continue, including stroke and STEMI.
- There are no anticipated ambulance access changes, including planned construction detours, in the coming months.
- Current Alvarado patients will transition to UC San Diego Health patients on December 11.
- During the next Regional Communication System radio re-banding update, radio talkgroups will transition from ALVR to a new designation. Direct radio communications with the UCSD East Campus Medical Center should be completed on the existing ALVR talkgroup in BLS Zone.

Realtime Emergency Department Data Pilot Program Expansion
November 29, 2023, 1:15 PM PDT
In collaboration with hospital leaders and the Hospital Association of San Diego and Imperial Counties, the San Diego County EMS Office deployed an Emergency Department (ED) Impact Status Scorecard. The ED Impact Status Scorecard is a novel system stress indicator allowing hospitals to communicate real-time facility capacity. This system facilitates the ongoing partnership between hospitals, EMS providers, and County EMS. The successful pilot program, initiated May 2023, is now available for use by all San Diego County ED healthcare teams.
You can view the Impact Status Scorecard notification here: Impact Status Scorecard Pilot Program Expansion

Health Officer Order for Annual Influenza Season
October 17, 2023, 11:35 AM PDT
The annual influenza season is upon us. The health officer order is evergreen and in force through the designated influenza season (November 1-March 31). The influenza letter requires, among other things, that healthcare personnel (including EMS credentialed personnel) wear a mask in patient care areas if they choose to not be vaccinated for influenza. As a reminder, the "Jury Duty letter" has been discontinued, as any jury summons can be deferred for any reason anytime.
You can view the health order here: Health Officer Order (HOO) - Annual Influenza Season

2024 - 2025 Treatment Protocol Revision
October 5, 2023, 1:50 PM PDT
The 2024-2025 Treatment Protocol Revision public comment period closed on October 1, 2023. Your feedback and subject matter expertise plays an important role in evaluating existing protocols. The San Diego County EMS Office will be taking the next several months to conduct an extensive and in-depth review of every recommendation submitted.
We would like to take this opportunity to thank everyone who provided valuable recommendations for improvement on our treatment protocols. Your contributions help support our goal of high quality, patient-centered care.

EMS Mobile App is Now Available

The San Diego County EMS Office is pleased to announce our new EMS Mobile App!
The app is now available to the community at emsmobile.sandiegocounty.gov.
The EMS Mobile App is a browser-based application and works on any device with an internet connection and web browser. The app allows users to easily search through all protocols and policies using keywords. In addition, users can bookmark specific protocols and policies to quickly access them at any time.
The EMS Mobile App also has a references section with important resources for our hospital and prehospital healthcare professionals. Please submit any feedback or functionality issues to EMSNotifications@sdcounty.ca.gov.

2023 - 2024 Protocol Updates
2023 - 2024 protocol packet available now.
All changes take effect July 1, 2023.
Please see the protocol change log and protocol update slides for updates.

Patient-Centered Care Modification from Paramedic to EMT Transport from Scene to Hospital
Following removal of the tool that permitted EMTs to transport eligible patients after on-scene paramedic treatment during periods of high system stress, the San Diego County EMS Office received requests from EMS prehospital and hospital professionals for clarification of the currently authorized use of EMS Policy S-412.
The EMS Medical Director has issued the Patient-Centered Care Modification from Paramedic to EMT Transport from Scene to Hospital memo to provide guidance and clarification on this policy.

EMS Cardiac Monitor Data Retention Community Consensus Guidance
A community workgroup was formed as part of the San Diego County EMS Office quality assurance/quality improvement (QA/QI) program. The workgroup has developed a consensus guidance document to provide communitywide standards in EMS cardiac monitor data management.
This guidance is intended to enhance the QA/QI process by ensuring standardization in EMS cardiac monitor data integration and retention. The EMS Medical Director has released a memo with more information.

Treatment on the EMS Gurney Community Consensus Guidance
A community workgroup has developed a consensus guidance document to provide focused, patient-centered guidance for hospital treatments that may be performed prior to patient Transfer of Care.
This guidance is intended to bring clarity to interventions that are reasonable to perform during this time interval to facilitate a smoother patient handover process. The EMS Medical Director has released a memo with more information.

Recommendation for COVID and Flu Vaccinations
With concern for the surge in COVID cases this fall, it is important for all of us to be up to date on our vaccinations. The harsh influenza season in the Southern Hemisphere suggests we may experience a severe flu season concurrent with this potential surge in COVID cases.
The EMS Medical Director strongly recommends COVID and flu vaccinations and has released a memo with more information.

Xylazine Alert for EMS
Please see the Xylazine Alert for EMS Professionals from the EMS Medical Director.
Additional information may be found at this National Institute of Drug Abuse page and this Drug Enforcement Administration info sheet.

Behavioral Health Program for First Responders
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.