San Diego County Emergency Medical Services Office

EMS Mobile App

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.
- Active System Stress Tools
  - 4:1 Patient to EMS Professional Ratio at EDs
  - 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
- Deactivated System Stress Tools
  - 9-1-1 Response Mode Alteration
  - Abbreviated Radio Report Option
  - Assess and Refer Option
  - DoD Beneficiary Destination Directive
  - EMS Treatment Considerations
  - Non-Patient Passenger Restrictions
  - EMT Transport Option Following On Scene Paramedic Treatment
  - Patient Masking Recommendation
  - 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)

Latest News

No-Notice Ambulance Arrival Data Collection

June 9, 2025, 8:00 AM PST

San Diego County EMS is gathering information on ambulance arrivals at emergency departments, with a specific focus on those with no-notice or late notification. These situations may reflect short ambulance transports, communication difficulties, or other operational causes. This data will inform the EMS System Redesign process.

ED personnel may complete this 30-second survey via phone or browser. ED staff may also download and print the QR code flyer.

EMS providers encountering Communication Failure should continue to use the P-405A Communication Failure Report.

County EMS appreciates these contributions.

California EMS Authority AB 40 Regulation Updates

June 3, 2025, 8:00 AM PST, updated June 26, 2025 12:00 PM

On June 18, 2025, the Emergency Medical Services (EMS) Commission voted and approved the emergency regulations for Chapter 1. Delivering Equitable and Person-Centered Care: Article 1.2 Ambulance Patient Offload Time. The OAL approved these regulations, which took effect on June 23, 2025.

The final regulations are available on EMSA’s Regulations webpage. Information about the Ambulance Patient Offload Time (APOT) data collection, tracking, and review is maintained at the EMSA APOT page.

EMS Corps: First Class has Commenced

June 3, 2025, 8:00 AM PST

San Diego County Fire's EMS Corps trains young people for careers in emergency medical services.

Throughout the 5-month program, students are provided with a stipend while receiving coaching, mentorship, and EMT training provided by experienced professionals.

The program experience includes:

A curriculum tailored to students' skills and abilities
Support for students' success
Help with job placement after graduation

More information and program information are available at the San Diego EMS Corps website. The application period for the summer 2025 course has concluded.

2025-2026 EMS Office Fee Updates

May 19, 2025, 8:00 AM PST

Changes effective July 1, 2025.

Fee Category	Amount
EMT/Advanced EMT Initial, Transfer, or Reinstatement Certification	$275 ($75 state fee plus $200 county fee)
EMT/Advanced EMT Renewal Certification	$237 ($37 state fee plus $200 county fee)
Paramedic Accreditation*	$200 county fee
Mobile Intensive Care Nurse Authorization*	$200 county fee
EMT or Advanced EMT Replacement Card	No fee (conditions apply)
EMT Out of County Status	No fee (conditions apply)
Other Healthcare Professional (Paramedic Intern, RN, etc.)	No fee (conditions apply)
Ambulance / CCT Provider Permit Application	$11,300 (annual)
Permitted Vehicle Inspection	$385 (per inspection)
Air Ambulance Permit	$5,500 (annual, per aircraft)
CE Provider Approval	$4,100 (every 4 years)
Base Hospital Designation	$61,000 (annual)
Trauma Center Designation	$66,000 (annual)

*Paramedic accreditation and MICN authorization renewals have no fee as long as the credential is current/has not expired.

2025-2026 Protocol and Policy Updates

May 1, 2025, 1:54 PM PST

We are pleased to announce the San Diego County EMS 2025-2026 protocols and policies are posted on the Prehospital Policies and Protocols webpage.

All protocol and policy updates take effect on July 1, 2025.

Please see the Protocol Packet, Protocol Presentation, and Protocol Changelog for more information about the updates.

EMS Medical Director's Guidance on Measles

April 22, 2025, 2:29 PM PST

In response to the ongoing 2025 measles outbreak in the United States, the San Diego County EMS Office has released the "EMS Medical Director’s Guidance on Measles for EMS Professionals" memo.

This guidance underscores the essential role of EMS professionals in combating the spread of this highly contagious disease. Additionaly, the memo highlights key actions to take before, during, and after a potential measles exposure. We encourage all EMS professionals and stakeholders to review this comprehensive document to ensure the safety of both patients and healthcare clinicians in San Diego County.

Ambulance Ordinance Update

December 29, 2024, 5:00 PM PST

Did you know the County of San Diego sets rules for ambulances, air ambulances, and non-emergency medical transportation providers to follow through an Ambulance Ordinance?

A lot has changed in our local EMS delivery system since the rules were last updated, so the Ambulance Ordinance is undergoing revisions to align with current best practices and medical transportation standards. As part of this process, we would like to hear from the community to help better understand their experience with the ambulance system and identify areas for potential improvement.

You can find more information about this project on the Engage San Diego County Ambulance Ordinance page.

Update Following San Diego County EMS Board of Supervisors Presentation

August 29, 2024, 3:00 PM PST

Memo Update after Board of Supervisors meeting

On Tuesday, August 27th, the San Diego County EMS Office presented an update to the Board of Supervisors regarding the Comprehensive Evaluations of the Base Station Hospital System and the Trauma Catchment Area Designations reports.

After the Board meeting, the County EMS Administrator and County EMS Medical Director provided stakeholders with information about next steps in the process. County EMS' priority focus areas include access to real-time medical direction, quality assurance and clinical impovement processes, and comprehensive, countywide EMS system coordination.

County EMS is committed to modernizing the EMS delivery system to enhance patient-centered, equitable EMS care for all San Diego County residents and visitors. We look forward to collaborating with all the various stakeholders in San Diego County throughout these next steps.

Base Station Hospital System & Trauma Center Catchment Area Designations: Final Report Posted

May 30, 2024, 12:00 PM PST

Comprehensive Evaluation of the Base Station Hospital System Cover Page

The County of San Diego EMS Office (CoSD EMS) is pleased to announce that Public Consulting Group (PCG) has concluded their Comprehensive Evaluation of the Base Station Hospital System and Trauma Center Catchment Area Designations.

The Comprehensive Evaluation of the Base Station Hospital System Report and the Trauma Center Catchment Area Designations Report have been posted on the County of San Diego's Engage webpage.

New Online Reporting Platform for APS Referrals

December 22, 2023, 9:21 AM PST

Aging & Independence Services (AIS) has transitioned to a new online reporting platform for APS referrals. To report suspected elder or dependent adult abuse or self-neglect, use the new link below:

APS Online Reporting Platform

You do not need a username and password to use the new online system. In addition, a SOC 341 form is no longer required if you use the online referral option above. Referrals can still be made by calling the AIS Call Center at 800-339-4661. The Mandatory Reporting page has also been updated.

"Emergency Department Impact Status Scorecard" Pilot Program

November 29, 2023, 1:15 PM PST

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 professionals, and County EMS. The successful pilot program, initiated May 2023, has been expanded for use across the entire San Diego County hospital system.

View the details here: ED Impact Status Scorecard Pilot Program Expansion

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: EMS Mobile App

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.

Patient-Centered Care Modification from Paramedic to EMT Transport from Scene to Hospital

After the deactivation of the tool that allowed EMTs to transport eligible patients following on-scene paramedic treatment during high system stress periods, the San Diego County EMS Office received requests from EMS prehospital and hospital professionals for clarification on the authorized use of EMS Policy S-412. The EMS Medical Director has issued a memo titled "Patient-Centered Care Modification from Paramedic to EMT Transport from Scene to Hospital" 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 an EMS Cardiac Monitor Data Retention Community Consensus Guidance 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 Treatment on the EMS Gurney Community Consensus Guidance 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 strong recommendation for COVID and flu vaccinations 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.