Medical Control for EMS services generally has 2 distinct and separate components that providers utilize when caring for pre-hospital patients.
OFF-LINE MEDICAL CONTROL consists of a Medical Control committee who oversees this document – a carefully reviewed and agreed upon set of pre-hospital care protocols. Emergency Physicians from Mercy Hospital and Freeman Health System, as members of the Medical Control Committee, authorize licensed paramedics (EMT-P) and emergency medical technicians (EMT-A) to utilize these medical protocols in the care of their patients.
ON-LINE MEDICAL CONTROL (OLMC) consists of “day-to-day” Emergency Physician consultation available via radio from each participating medical facility. Emergency Physicians are available at each facility for consultation or orders 24 hours a day.
Healthcare providers who are on-scene pose a dilemma for EMS providers. These providers may be physicians, nurses, advanced care nurses, physician assistants, or off-duty EMS providers. Non-physician providers MAY NOT give orders to EMS providers and are to only participate at the direction of the senior paramedic.
The appearance of a physician on-scene is a different matter. When presented with this situation, the senior paramedic should attempt to verify their claim. Once verified, it should be determined whether the physician is the “patient’s personal physician” OR a physician with no physician-patient relationship (“intervener physician”).
In the case of the patient’s personal physician, they may assume control of on-scene medical treatment IF: OLMC is advised AND the physician agrees to sign the EMS medical record. The personal physician SHOULD ride with the patient or agree to meet them at the medical facility.
When an intervener physician is on-scene, they must first consult with OLMC before assuming authority over EMS providers. It is the option of OLMC whether or not to allow the intervener physician this authority. If authority is given, the intervener physician should sign the EMS medical record. They may or may not, after consultation with OLMC, accompany the patient to the medical facility.