Physician or Nurse on Scene

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The care of the patient at the scene of an emergency should be the responsibility of the individual in attendance who is the most appropriately trained in providing pre-hospital stabilization and transport. As an agent of the Medical Director of an EMS system, the Paramedic / EMT, represents that individual. Occasions will arise when a physician on the scene will desire to direct pre-hospital care. A standardized method for dealing with these contingencies will optimize the care given to the patient.

  • The physician desiring to assume care of the patient must:
    • Provide documentation of his status as a physician (M.D. or D.O.).
    • Be licensed to practice medicine in the State of Florida.
    • Allow documentation of his or her assumption of care on the Patient Care Report.
    • Contact with Medical Control at the receiving facility must be established as soon as possible. The physician assuming responsibility at the scene should be placed in contact with the Medical Control Physician and acknowledgment of his or her acceptance of responsibility confirmed.
    • Orders provided by the physician assuming responsibility for the patient, should be followed as long as they do not, in the judgment of the Paramedic endanger patient well-being. The Paramedic may request the physician to attend to the patient during transport if the suggested treatment varies significantly from Standing Orders.
    • If the physician's care is judged by the Paramedic to be potentially harmful to the patient, the Paramedic should:
      • Politely voice his or her objections.
      • IMMEDIATELY place the physician on the scene in contact with Medical Control for resolution of the problem.
      • When conflicts arise between the physician on the scene and Medical Control, EMS personnel should follow the directives of the Medical Control Physician. Offer no assistance in carrying out the order in question, but provide no resistance to the physician performing this care. If the physician on scene continues to carry out the order in question, offer no assistance and enlist aid from law enforcement.
    • All interactions with physicians on the scene must be completely documented in the Patient Care Report.
    • Should a Registered Nurse present at an emergency scene and wish to participate in administering care for the patient he / she must function within the realm of F.S. 401 and F.S. Chapter 464.