Coastal Valleys EMS Agency News

The Coastal Valleys EMS Agency has released EMS Special Memorandum 23-001 

 This EMS Special Memo is intended to clarify that the Stat Ambulance Transfers Policy allows for the emergency transport of “acute, unstable patients in need of immediate intervention by a facility offering a higher level of care” regardless of treatment location within an acute care facility.

The current language states that patients eligible for a Stat Ambulance transfer are limited to those being treated and located in an Emergency Department. In contrast, the EMS Agency would like to clarify that the policy is not intended to limit eligibility based on patient’s treatment location. An example might be a patient in a critical care unit with a STEMI and no available interventional cardiology available at the facility.

There is no change in the intent to limit the use of 911 ambulance resources to such critical cases. This clarification regarding patient location is not intended to expand the use of this policy to facilitate transfers of patients that are not in extremis or as a substitute for ALS or CCT transfer resources.

Changes are being drafted to the current policy to clarify intent, patient eligibility, and process. This EMS Special Memo is effective immediately.  The current Stat Ambulance Transfer Policy will be released for public comment following the release of this EMS Special Memo.

Please do not hesitate to contact the EMS Agency with any questions or concerns; staff contact is This email address is being protected from spambots. You need JavaScript enabled to view it.

New and Revised Treatment Guideline Public Comment Release

Coastal Valleys EMS Agency has released a number of revisions to patient care Treatment Guidelines. Public Comment period will be open until March 21, 2023.

Please see this Summary of Changes for a detailed list of revisions.

These policy updates were made in collaboration with the Regional Policy Advisory Committee and approved by Dr. Mark Luoto. CVEMSA thanks our EMS system partners for the investment in time and effort in improving patient care. 

The individual policies can be found here:

7102 Dysrhythmia

7802 Uncontrolled Bleeding/Tourniquet

7920 Synchronized Cardioversion

7919 External Pacing

7918 Intraosseous (IO) vascular Access

Please send all public comment or questions to Carly Sullivan. This email address is being protected from spambots. You need JavaScript enabled to view it.

Administrative Policy 2012 Paramedic Accreditation

Revised 12/06/2022 effective 01/06/2023

CVEMSA Administrative Policy 2012 Paramedic Accreditation effective January 6, 2023, as well as public comment and responses to comments received during the public comment period are linked below:

Administrative Policy 2012 Paramedic Accreditation

Public Comment Matrix with response by CVEMSA

The revised policy reinforces the standard accreditation practices of the local EMS system while acknowledging the need to retain the flexibility to make adjustments on a temporary basis as has been the case during the COVID-19 Pandemic. The EMS Agency would like to thank stakeholders who provided comments and suggested language changes, some of which was incorporated into the final version. The EMS Agency Medical Director does not plan on rescinding any accreditation waivers or modifications currently in place on the policy implementation date, but is considering a timeframe for a return to the normal requirements and will consult with system stakeholders on that issue prior to making changes.

Please direct any question regarding this posting to: This email address is being protected from spambots. You need JavaScript enabled to view it.

The Coastal Valleys EMS Agency is preparing to release Administrative Policy 4013, Leave Behind Naloxone Authorization.

When an ambulance or fire service responds to a 911 call for an overdose, First Responder firefighters, Law Enforcement, EMT’s and Paramedics administer Naloxone to prevent a patient from dying but do not provide any additional Naloxone to treat subsequent overdoses at the emergency scene. Coastal Valleys EMS Agency is releasing this policy as a novel approach for EMS and Fire Department participation to help prevent death due to overdoses.

This policy will allow EMS and Fire Department providers to implement an agency/department specific Leave Behind Narcan program and provides Medical Control authorization to Leave Naloxone at an emergency scene when subsequent overdose is suspected.

 Review the policy in the Draft Policy section of the CVEMSA website

Public Comment for this revision will be open through Friday, February 3, 2023.  Comments should be sent via email to: This email address is being protected from spambots. You need JavaScript enabled to view it.

Coastal Valleys EMS Agency values stakeholder feedback and encourages comments.

Coastal Valleys EMS Agency has released EMS Special Memorandum 22-004 EMT Draw Epinephrine Accreditation

The Special Memo provides the process for EMS service providers to obtain approval for the optional scope of practice use of draw up epinephrine in place of basic scope autoinjectors. 22-004 incorporates four addendum documents including:

• A template MOU for physician-to-physician delegated Optional Skills Medical Director designation
• A training and competency verification check off sheet
• A roster to list provider agency EMTs whom have completed the training and verification process
• Alternative medical direction for the use of draw up epinephrine in place of autoinjector delivery of the medication.

Links to these forms are included within the Special Memo.

CVEMSA would like to thank and recognize Marin County Fire for the training material and the benefit of their experience as well as our fire service partners at Sonoma County Fire District (Bodega Bay) who worked with Dr. Luoto on program adaptation for Sonoma and Mendocino Counties. 

During the one-year allowable term of this Special Memo, CVEMSA will work with system partners on a formal policy development process to incorporate the elements of the memo into our permanent policy and treatment guideline publications.  

The EMS Agency has released a memorandum for the purpose of updating our stakeholders on the Tiered Response development process including the increased use of Basic Life Support ambulances within the Sonoma County system. The full memo is available here: EMS Special Memo 22-003