San Andreas Fire & EMS Standard Operating Procedures

Status: Current

Effective date: August 24, 2026

Last revised: August 24, 2026

This document establishes department operations. Personnel shall also comply with current statewide policy, medical direction, and department directives.

These Standard Operating Procedures establish the minimum standards for emergency medical services, fire suppression, rescue operations, incident command, public assistance, and department conduct.

All personnel shall operate within their approved training, certification, assignment, scope, and available department resources.

1. Mission and priorities

San Andreas Fire & EMS personnel shall protect life, stabilize incidents, reduce preventable harm, coordinate safe transport, and document care. Operational priorities are:

1. responder and public safety;
2. rescue and life preservation;
3. incident stabilization;
4. property and environmental conservation; and
5. evidence preservation after immediate hazards are controlled.

2. Readiness

Before entering service, members should verify their certification, unit assignment, radio, CAD access, personal protective equipment, and vehicle status. Members may perform only care and operations supported by approved training, current authorization, and available department resources.

3. Response levels

Use the response level assigned by dispatch or incident command. Warning equipment permits a priority response but does not remove the duty to drive with care. Reduce or discontinue an emergency response when updated information no longer supports it.

Stage away from violence, hazardous materials, unstable scenes, or law-enforcement operations until the responsible agency declares an access route reasonably safe.

4. Incident command

The first qualified unit should provide an arrival report, identify obvious hazards, establish command when needed, and request appropriate resources. Command should announce:

• incident designation and location;
• command post or operating position;
• current conditions and priorities;
• staging area;
• access and egress routes; and
• resource requests.

Command may transfer to a more qualified or better-positioned member after a clear briefing. Unified command should be used when fire, EMS, law enforcement, public works, or another agency shares significant responsibility.

5. Patient contact

5.1 Consent

Explain the proposed assessment and treatment in clear clinical language. A conscious patient with decision-making capacity may accept or refuse care. Consent may be implied for an unresponsive patient or immediate life threat when permitted by policy.

Protect patient dignity. Avoid unnecessary graphic detail, use concise clinical descriptions, and discontinue nonessential detail when a patient requests it.

5.2 Assessment

Assess the patient progressively. Begin with scene observations, observable signs, and the chief complaint. Obtain relevant history, perform an examination, record and trend vital signs, and use available diagnostics within certification and authorization.

Form a clinical impression from the history, examination findings, vital signs, available diagnostics, and response to care. Use language such as “findings are consistent with,” “suspected,” “concern for,” or “cannot exclude” when certainty is not supported. Update the impression as new findings become available.

5.3 Treatment and transport

Provide interventions within certification, authorization, and protocol. Explain significant procedures, reassess after treatment or change, and transport to the appropriate receiving facility when indicated. The receiving facility should receive a concise handoff covering the complaint, relevant history, findings, vital-sign trends, diagnostics, interventions, response, current clinical impression, and safety concerns.

5.4 Provider levels

The department recognizes EMT-B, EMT-A, and EMT-P provider levels. This SOP does not create detailed medication or procedure authority. Consult Provider Certification and Scope and the current approved clinical protocols.

6. Refusal of care

A refusal should be accepted when the patient is able to understand the situation, available options, and reasonably foreseeable consequences of accepting or declining care. Document:

• the assessment offered and completed;
• apparent capacity;
• information and alternatives explained;
• the patient’s decision;
• witnesses or medical control consultation when available; and
• advice to seek help if the condition worsens.

Impairment, severe distress, altered consciousness, or an immediate self-harm risk may require protective-custody coordination under department and statewide policy.

7. Death and resuscitation scenes

Follow current resuscitation, consent, medical-control, and pronouncement policy. Avoid unnecessary graphic detail. Once death is determined through the approved clinical process, preserve the scene, notify law enforcement or the coroner as appropriate, and avoid moving property unless required for safety.

Fire & EMS personnel should document assessment findings and care without making unsupported criminal conclusions. Complete the required patient care record and death or pronouncement documentation.

8. Fire incidents

For structure, vehicle, wildland, or industrial fires:

• establish command and announce conditions;
• identify life hazards, exposures, access, utilities, and collapse risks;
• create operational zones and staging;
• coordinate rescue, suppression, ventilation, and accountability through approved departmental methods;
• request additional alarms or specialized resources early; and
• conduct a final accountability and scene-status report.

Only trained department personnel should direct interior operations or specialized rescue. Department protocol does not replace required training and competency.

9. Vehicle collisions and rescue

Position units to protect the scene without creating unnecessary obstruction. Coordinate traffic control with law enforcement, address fire or hazardous-energy concerns, establish patient access, and preserve reasonable paths for other responders.

Patient care takes priority. When practical, avoid unnecessary alteration of evidence and advise law enforcement before vehicles are moved. Document any movement required for rescue or safety.

10. Hazardous materials and suspicious substances

Do not approach, touch, smell, open, or test an unknown hazardous substance unless training, scope, protective equipment, and department authorization permit it. Establish a safe perimeter, position uphill or upwind when appropriate, deny entry, request the designated resource, and identify exposed persons.

Suspected explosive devices remain a law-enforcement and bomb-resource matter. Fire and EMS should stage for rescue and fire protection at the location designated by command.

11. Mass-casualty incidents

An MCI exists when patient needs exceed immediately available resources. Command should establish medical coordination, request additional units, designate triage, treatment, and transport areas, and maintain patient tracking.

Use department-approved triage categories, concise clinical descriptions, and consistent patient tracking. Transport decisions should balance severity, available facilities, and scene safety.

12. Behavioral health and self-harm scenes

Use calm communication, reduce unnecessary personnel and stimulation, and coordinate with law enforcement only to the degree needed for safety. Assess decision-making capacity, medical causes, immediate risk, and available support. Do not promise confidentiality that cannot be maintained. Document the patient's statements, observed behavior, assessment, safety plan, consultation, and disposition.

13. Medication, controlled substances, and patient property

Patient medication and valuables should remain with the patient unless safety, evidence, or receiving-facility policy requires transfer. Document any property taken into custody and the recipient. Suspected contraband should not delay urgent care.

Medical records are confidential. Share information with law enforcement only when the patient consents, a valid process applies, or immediate safety requires it under current policy.

14. Coordination with law enforcement

Law enforcement controls criminal threats, custody, traffic enforcement, and evidence. Fire and EMS controls patient care and fire-rescue operations. Neither function should direct the other’s professional decisions outside immediate safety and unified command.

Persons in custody remain patients. Restraints may be adjusted when necessary for care if safety can be maintained. Medical information should not be broadcast unnecessarily.

15. Patient care reports

Complete a patient care report for contacts involving assessment, treatment, medication, transport, refusal, transfer of care, death or pronouncement, or another circumstance requiring documentation under department policy.

Include, as applicable:

• patient information available through authorized systems;
• dispatch, response, arrival, contact, transport, and transfer times;
• scene conditions, hazards, and mechanism or nature of illness;
• chief complaint, history, assessment, and examination findings;
• vital signs, trends, diagnostics, and clinical impression;
• treatments, procedures, medications, dose, route, time, and response;
• changes in condition and reassessment;
• transport, destination, receiving handoff, and final disposition;
• refusal, death or pronouncement, medication error, or protocol deviation details; and
• a clear chronological narrative.

Use objective clinical language. Separate patient statements, witness information, provider observations, and clinical conclusions. Do not include out-of-character personal information or unsupported criminal conclusions.

See Patient Care Report Documentation for the documentation standard.

16. Quality review and critical incidents

Supervisor review is required for responder injury, death in care, major refusal dispute, medication or property discrepancy, significant exposure, mass-casualty response, unusual force around patient care, or formal complaint.

An after-action review should identify what happened, what worked, what needs improvement, and assigned corrective actions without turning the process into public blame.