San Bernardino, California — Inland Counties Emergency Medical Agency
ICEMA provides emergency medical services oversight for San Bernardino County and surrounding inland counties (Inyo, Mono). Their policies and protocols govern EMT, AEMT, and Paramedic practice throughout the region. The current protocol manual is effective July 1, 2026 and includes significant updates including D10W for hypoglycemia, updated opioid withdrawal protocols, and new medication standard orders.
EMTs operating in ICEMA jurisdiction (San Bernardino, Inyo, and Mono Counties) must follow ICEMA EMT protocols effective July 1, 2026. Scope includes standard BLS interventions per California EMT scope plus ICEMA-specific standing orders for epinephrine auto-injectors, naloxone (including new 4 mg IN loading dose for suspected fentanyl overdose), oral glucose, and aspirin for ACS. CPR per AHA guidelines at 30:2 ratio, compression rate 100-120/min, depth at least 2 inches. EMTs may assist patients with prescribed nitroglycerin.
Paramedics in San Bernardino, Inyo, and Mono Counties must be accredited through ICEMA (Reference 1030). Paramedic scope includes all ALS interventions per ICEMA Paramedic protocols effective July 1, 2026 (Ref 11010). Includes medication administration per updated medication standard orders including D10W (not D50), fentanyl (max 200 mcg total), buprenorphine-naloxone (Suboxone) for opioid withdrawal, blood products (LTO+WB/pRBCs for approved providers), advanced airway management, cardiac monitoring with 12-lead acquisition, and more. Cardiac arrest antiarrhythmic: Lidocaine (NOT Amiodarone).
| Item | Cost |
|---|---|
| California EMT License | $50/2yr renewal |
| ICEMA Accreditation (Paramedic) | Contact ICEMA |
| National Registry | $110 (initial) / $70 (renewal) |
EMT: Complete state-approved EMT program, pass NREMT cognitive + psychomotor, obtain CA state EMT license, register with San Bernardino County ICEMA | Paramedic: Complete accredited paramedic program, pass NREMT-Paramedic, obtain CA Paramedic License, complete ICEMA paramedic accreditation process including local written/skills testing