PHYSICIAN ON-SCENE*

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Policy:

The medical direction of prehospital care at the scene of an emergency is the responsibility of those most appropriately trained in providing such care. All care should be provided within the rules and regulations of the state of North Carolina.

Purpose:

·         To identify a chain of command to allow field personnel to adequately care for the patient when a non-medical control physician is on-scene.

·         To assure the patient receives the maximum benefit from prehospital care.

·         To minimize the liability of the EMS system as well as the on-scene physician.

Procedure:

1.       When a non-medical control physician offers assistance to EMS, or when a physician is attending a patient with whom he/she does not have an ongoing patient relationship, EMS personnel must review the highlighted requirements noted below with the physician.

2.       When the patient is being attended by a physician with whom they have an ongoing patient relationship, EMS personnel may follow orders given by the physician if the orders conform to current Iredell County ALS Treatment Protocols, and if the physician signs the Patient Care Report (PCR). Notify medical control at the earliest opportunity. Any deviation from local EMS protocols requires the physician to accompany the patient to the hospital.

3.       Prehospital personnel will always assess and manage the patient upon arrival at the scene regardless of on-scene physician direction.

4.       In order for an on-scene physician to assume control of patient care, he/she must:

·         Receive approval to assume the patient’s medical care from an online Medical Control physician.

• Show proper identification including a current North Carolina Medical Board Registration Card. Ideally, the physician will have experience in an emergency and/or critical care setting.
• Accompany the patient to the hospital.
• Carry out any interventions that do not conform to EMS Protocols. EMS personnel cannot perform any interventions that are not included in their protocols.
• Sign all orders on the PCR.
• Assume all medico-legal responsibility for all patient care activities until care is transferred.
• Complete the On-Scene Physician Form

5.       EMS personnel may carry out orders from an approved on-scene physician as long as the orders do not exceed, nor conflict with, Iredell County ALS Treatment Protocols. The on-scene physician must sign for all orders on the PCR.

6.       EMS personnel should always contact the medical control physician if they are uncomfortable with any part of the treatment being provided by an on-scene physician.