Provider Certification and Scope

Status: Current structure

Effective date: August 24, 2026

Last revised: August 24, 2026

San Andreas Fire & EMS recognizes three provider levels:

• EMT-B
• EMT-A
• EMT-P

This page establishes the certification structure. It does not create a detailed medication or procedure list.

Scope is determined by authorization

A provider may perform only care that is supported by:

• current certification;
• department training and competency;
• individual authorization;
• available equipment;
• current protocol; and
• medical-control direction when required.

Certification level alone does not authorize an unfamiliar procedure. A provider who lacks training, equipment, or current authorization should provide care within the available scope and request an appropriately qualified resource.

EMT-B

EMT-B is the foundational provider level. Personnel perform patient assessment, immediate life-safety care, routine transport care, reassessment, and documentation within the department's basic scope.

EMT-A

EMT-A personnel perform the EMT-B role and may provide additional assessment or treatment authorized by the department's advanced scope. Exact procedures and medications must be published in an approved scope reference before use.

EMT-P

EMT-P personnel provide advanced assessment and treatment within the department's paramedic scope. They may support higher-acuity decision-making, consultation, transport planning, and clinical leadership when assigned. Exact advanced procedures and medications must be published in approved protocols.

Shared responsibilities

Every level remains responsible for:

• scene and patient safety;
• progressive assessment;
• obtaining and trending vital signs;
• recognizing a need for additional resources;
• working within scope;
• explaining care and respecting informed decisions;
• reassessing after intervention or change; and
• completing an accurate patient care report.

Scope questions and deviations

When scope is unclear, pause the non-emergent intervention and seek a supervisor or medical-control decision. Emergency care should remain within the provider's training and the resources available.

Document any medication error, unplanned outcome, protocol deviation, or care outside the expected pathway and notify the appropriate clinical supervisor.