Coastal Valleys EMS Agency News

The Coastal Valleys EMS Agency has released proposed revisions to CVEMSA Administrative Policy 4008, Turnover of Patient Care for a 60-day public comment period. 

The policy revisions are intended to support the increased use of Basic Life Support ambulance transport where such utilization is medically appropriate for patients. The policy provides direction to EMS care providers for patient-centric decision making. The revised version of the policy is available for review here. The public comment period will remain open through January 22, 2024. Please submit all comments to: james.salvante@sonoma-county.org

All comments received will be reviewed and responses published with any final version of the policy. 

The Coastal Valleys EMS Agency has released the draft version of Administrative Policy 4001 Ambulance Service Provider Permits.

The draft is available for review here: 4001 Public Comment Version 

The public comment period will be open through November 28, 2023. Please send any comments to: This email address is being protected from spambots. You need JavaScript enabled to view it.

The Coastal Valleys EMS Agency has released EMS Special Memorandum 23-002 Medication Substitution

The memo is intended to provide authorization for alternative medication usage and the use of expired medication in response to a national shortage of Albuterol in liquid form. The memo also provides for paramedic Metered Dose Inhaler administration of Albuterol after training.

The memo is available here and includes an embedded training document link.

Any questions regarding the training material or medication administration may be directed to Dr. Mark Luoto, EMS Agency Medical Director at: This email address is being protected from spambots. You need JavaScript enabled to view it.

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 Coastal Valleys EMS Agency has released Special Memo 21-003 intended to authorize the implementation of a CMS-approved ET3 Pilot Project within the LEMSA jurisdiction. This Special Memo is required due to a CMS approval deadline of December 31 2021 by any regulatory agencies approving such pilots.

Greater discussion about the expansion of the ET3 study component(s) including on-scene treat and release, telemedicine and alternate care facility diversion/transportation within CVEMSA will occur at EMCC, MAC, and the policy revision group. Those components need to have robust stakeholder discussion and input. Ultimately, operationalized treatment guidelines and policy infrastructure will be built through a collaborative effort between CVEMSA and outside interested parties.

2021 Treatment Guidelines Revisions

Public Comment Period March 15, 2021- May 15, 2021

Coastal Valleys EMS Agency is proposing revisions to several Treatment Guidelines. System stakeholders worked with the EMS Agency Medical Director and staff to develop the following public comment versions:

•     7003 Cardiac Arrest Management
•     7102 Dysrhythmias
•     7501 Imminent Delivery
•     7906 Administration of Ketorolac
•     7908 CPAP

Link to 2021Draft Treatment Guidelines document
Please note the linked file is a version of the CVEMSA Treatment Guidelines manual that includes edits to the above treatment guidelines open for public comment. The reminder of the CVEMSA Treatment Guidelines are not under revision during this cycle. System participants and stakeholders are welcome to provide feedback on any CVEMSA policy at any time, but only the five guidelines listed above are open for changes in this policy development cycle.

Please forward comments via fax or email to:

Carly Sullivan
Advanced Life Support Coordinator
Coastal Valleys EMS Agency
195 Concourse Blvd., Suite B
Santa Rosa, CA 95403
707-565-6510 FAX
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.