Seal of the City and County of San Francisco
City and County of San Francisco

To view graphic version of this page, refresh this page (F5)

Skip to page body

Learn More about the EMS Division

SFFD Emergency Medical Services

EMS Configuration

Medical Call Statistics

History of EMS in San Francisco

EMS Quality Improvement Program

EMS Clinical Programs & Research

SFFD Emergency Medical Services

The San Francisco Fire Department is a permitted ambulance provider in the City and County of San Francisco, dedicated to providing excellent EMS care for the full spectrum of medical emergencies.  The Department follows the local ambulance ordinance and adheres to the policies and protocols for pre-hospital care set by the San Francisco Emergency Medical Services Agency (SF EMSA).  All Department paramedics and firefighter/paramedics are licensed by the State of California EMS Authority and accredited with SF EMSA.  All emergency medical technicians and firefighter/EMTs are certified with SF EMSA.  All accreditation, certification and licensing is in accordance with Division 2.5 of the Health and Safety Code, the California Code of Regulations, Title 22, Division 9, and SF EMSA policies 2040 and 2050. 

Current SF EMSA policy and protocol manuals are available at: 

Policy & Protocol Manuals (DEM, Division of Emergency Services)

All patient contact is documented; records of the medical care provided to our patients and bills generated for the emergency medical services rendered are maintained by the Department.  Only authorized persons, in accordance with the Health Insurance Portability & Accountability Act (HIPAA), may obtain copies of these records.  Procedures are as follows: 

Medical & Billing Records

As licensed and certified health care professionals, paramedics and EMTs report incidents of suspected dependent adult/elder abuse or neglect to the SF Department of Aging & Adult Services; suspected child abuse or neglect to the SF Human Services Agency; suspected domestic violence and firearm injuries to the SF Police Department; and, on-the-job injuries or illness to the CA Division of Occupational Safety & Health.  Any subsequent investigations are handled by the respective department or agency.

EMS Configuration

In 1997, the Department of Public Health, Paramedic Division merged with the San Francisco Fire Department.  This merger placed ambulances at Fire Stations and adjusted the paramedic work schedule to 24-hour shifts.  During the years 1999 through 2004, the Department developed the implementation of paramedic-staffed engine companies, bringing a higher level of care to patients faster.   Beginning in 2004, a reconfiguration of ambulance deployment was implemented, moving the 24-hour station-based ambulances to short-shift strategically-placed ambulances.  As part of the reconfiguration, geographically-relevant posting locations have been implemented for the positioning of ambulances, and the scheduling of ambulances has been adjusted to accommodate the busiest times of the day.  The new deployment, completed in July 2009, has benefited the Department in flexibility of scheduling, increased efficiency, and improved response times, creating a more mobile response force to cover the City and County of San Francisco. 

The Department is working closely with the SF Department of Emergency Management to continue to improve our efficiencies and decrease our response times.  There are plans to implement a fully operational Automatic Vehicle Locator (AVL) system, which will allow the Computer Aided Dispatch system to pick the closest appropriate vehicle for a particular medical call.  The deployment of a Predictive Intelligence system is also being considered, which will decrease response times by optimizing the location of our available dynamic ambulances based on expected call volume, location from historical data, and traffic patterns.

Medical Call Statistics

Each and every 911-call could potentially be for someone in a life-threatening situation.  Arriving quickly and safely to the scene, with first-responder professionals equipped with the essential medical supplies and rescue gear, can make the difference between life and death.  For this reason, and to ensure that patients receive the highest quality of care in the shortest amount of time, paramedic/EMT-staffed fire apparatus, which are more plentiful and usually are the first to arrive on-scene, are dispatched along with an ambulance on all emergency code 3 calls.

The Department responds to an average of over 73,000 EMS calls per year (more than 200 per day), and as of 2010, provides about 80% of the ambulance response in the City and County of San Francisco.

Fire Calls-for-Service (DataSF.org)

This dataset includes all 911 fire unit responses to calls.  Each record includes the call number, incident number, address (block), unit identifier, call type and disposition.  All relevant time intervals are included.  Since this dataset is based on responses, there are records for each unit responding to the same call number.  This dataset also includes 911 responses by private ambulance companies.

History of EMS in San Francisco

San Francisco has a long history of providing emergency medical services to its citizens, beginning back in the days when ambulances were drawn by horses.  The San Francisco Fire Department proudly continues that long-standing tradition by providing quality emergency medical care to the citizens and visitors of San Francisco.  To view images of San Francisco’s EMS history, visit the San Francisco Guardians of the City website, dedicated to preserving the heritage and recording the history of San Francisco’s bravest and finest:

Guardians of The City – EMS/Paramedics [http://guardiansofthecity.org/ems/index.html]

Ambulances: Horse-Drawn & Motorized [http://guardiansofthecity.org/ems/ambulances/index.html]

EMS Quality Improvement Program

The San Francisco Fire Department EMS Division is committed to continuous evaluation and improvement of the process we use to provide quality emergency medical care.  The EMS Division treats all clinical review with confidentiality and respect, with the goal of improving communication and team work with field practitioners and receiving hospitals.
The San Francisco Fire Department EMS Division, under the guidance of the Department’s Medical Director, oversees and manages the delivery of emergency medical services in the following ways:

  • Clinical Performance Management- ensures the Department is providing the highest quality out-of-hospital health care to the public through compassionate, proficient practitioners.
  • System Operations- focuses on the means by which the Department directly delivers its services to the public, assuring continuity of service with a fully integrated Engine-based first response and a dynamic transport ambulance workforce.  Issues of fleet deployment and management, unit staffing and configuration, and logistics are examples of functions that fall within systems operations.
  • Risk Management- seeks to identify, evaluate, and reduce opportunities for injury to the public or Department members as a result of Department activities, with a strong emphasis on prevention and error reduction.
  • Education and Training- provides SFFD personnel with the education and training skills necessary to maintain a high degree of proficiency in the delivery of emergency care and services.  The Division of Training EMS staff is responsible for curriculum development and training oversight and the Medical Director ensures the training program reflects the best contemporary practices in EMS education.
  • Administration- focuses on internally-oriented management, support, and oversight functions necessary to ensure effective and efficient Department operations.  Examples of administrative functions include finance and budgeting, compliance with federal and state regulations, human resource management, medical records management and release of information, and customer service.
  • Research- includes activities to evaluate new practices, techniques, and equipment with the intent to improve emergency care.  Activities include sponsored clinical investigations, pilot projects, and investigations of new treatment modalities.

EMS Clinical Programs & Research

The SFFD EMS Division is continuing the development of new improvements to the system by way of clinical programs.  They include:

  • Use of the non-invasive Continuous Positive Airway Pressure (CPAP) device for patients in respiratory failure;
  • Use of 12-Lead Electrocardiogram (EKG) for early identification of patients experiencing an ST segment Elevation Myocardial Infarction (STEMI), benefiting those patients needing timely angioplasty or clot busting drugs;
  • Use of Adult Interosseous device for patients who can benefit from the administration of IV medications when IV access is otherwise unobtainable;
  • Use of the King Tube as a rescue airway device when endotracheal tube placement is unsuccessful;
  • Expanding the medical direction for public and private Automatic External Defibrillator (AED) Programs within San Francisco, to improve overall patient outcomes from cardiac arrest; and,
  • Implementing electronic documentation of medical treatment provided to improve monitoring of EMS system and to comply with federal, State and local requirements. 

Clinical Research
To assist in the improvement of advanced pre-hospital emergency medical care, the San Francisco Fire Department frequently participates in research studies.  Activities in this area include sponsored clinical investigations, pilot projects, or investigations of new treatment modalities.  Refer to the link below to view a list of past, current and proposed SFFD research activities.

Clinical Research

Partnering with the Medical Community: Sudden Cardiac Arrest Symposium
In August 2009, the San Francisco Fire Department and San Francisco General Base Hospital hosted an all day symposium on the latest advances in research and pre-hospital treatment for Sudden Cardiac Arrest.  Over 100 persons were in attendance.

Partnering with San Francisco City College: EMT & Paramedic Training Programs
The Department has a long-standing relationship with San Francisco City College, providing educational opportunities for students in Fire Science and in the Emergency Medical Technician Paramedic Program.  To help prepare the trainees for the practical aspects of their career, the Department provides CCSF EMT students observation ride-along opportunities with the ambulance crews and pre-hospital field internships for students in the CCSF Paramedic Program.

Partnering with University of California, San Francisco: EMS & Disaster Medicine Fellowship Program
The Department continues to increase its partnership with the UCSF, School of Medicine.  This relationship provides UCSF Emergency Medicine students with the opportunity to observe SFFD paramedics at work.  The Department also assists students in disaster planning exercises, as well as other related educational endeavors.  In return, the Department plans to gain valuable input from the UCSF Emergency Medical Services & Disaster Medicine students working closely within the EMS Division.


Last updated: 5/6/2010 2:26:06 PM