|(a) Control at the scene of a medical emergency shall
be the responsibility of the individual in attendance who is most
appropriately trained and knowledgeable in providing pre-hospital
emergency stabilization and transport.
(b) The prehospital provider on the scene is responsible
for the management of the patient(s) and acts as the agent of the
physician providing medical direction.
(c) If the patient's personal physician is present
and assumes responsibility for the patient's care, the prehospital
provider should defer to the orders of said physician unless those
orders conflict with established protocols. The patient's personal
physician shall document in his or her orders in a manner acceptable
to the EMS system. The physician providing on-line medical direction
shall be notified of the participation of the patient's personal physician.
(d) If the medical orders of the patient's personal
physician conflict with system protocols, the personal physician shall
be placed in communication with the physician providing on-line medical
direction. If the personal physician and the on-line medical director
cannot agree on treatment, the personal physician must either continue
to provide direct patient care and accompany the patient to the hospital
or must defer all remaining care to the on-line medical director.
(e) The system's medical director or on-line medical
control shall assume responsibility for directing the activities of
prehospital providers at any time the patient's personal physician
is not in attendance.
(f) If an intervenor physician is present at the scene
and has been satisfactorily identified as a licensed physician and
has expressed his or her willingness to assume responsibility for
care of the patient, the on-line physician should be contacted. Once
the on-line physician is contacted, he or she is ultimately responsible
for the care of the patient unless or until the on-line physician
allows the intervenor physician to assume responsibility for the patient.
(g) The on-line physician has the option of managing
the case exclusively, working with the intervenor physician, or allowing
the intervenor physician to assume complete responsibility for the
(h) If there is any disagreement between the intervenor
physician and the on-line physician, the prehospital provider shall
be responsible to the on-line physician and shall place the intervenor
physician in contact with the on-line physician.
(i) If the intervenor physician is authorized to assume
responsibility, all orders to the prehospital provider by the intervenor
physician shall also be repeated to medical control for recordkeeping
(j) The intervenor physician must document his or her
intervention in a manner acceptable to the local EMS.
(k) The decision of the intervenor physician not to
accompany the patient to the hospital shall be made with the approval
of the on-line physician.
(l) Nothing in this section implies that the prehospital
provider can be required to deviate from standard protocols.