Scene Choreograph Policy

When there is a question of "who is in charge" during a rescue service call, the following protocol shall be in effect and applies to EMS personnel who are qualified members of the EMS service responding to the service call:

I) Upon arrival to the scene by the service responding, initial assessment of the patient shall be completed as promptly as possible. If the patient is stable without any life-threatening problems or in need of higher level care, then any tiered unit enroute may be disregarded by the highest level of care provider present at the scene.

2) When a Paramedic, Nurse Exception (Paramedic or EMT-I), or EMT-I has arrived at the scene and, after their patient assessment it is clear that no higher level of care is indicated, then the Paramedic, Nurse Exception (Paramedic or FMT-I), or EMT-I may delegate the care to the provider with the next highest level of care certification as long as all reasonably anticipated needs can be met by that level of care provider. The Paramedic, Nurse Exception (Paramedic or EMT-I), or EMT-l shall continue to accompany the patient to the hospital if there is any concern that higher level of care would be needed and no certified provider as such would otherwise be in attendance with the patient. If no higher level of care is anticipated and the patient is stable then the Paramedic, Nurse Exception (Paramedic or EMT-I), or EMT-I may elect to leave the scene if there is agreement as such with the highest level of care provider remaining at the scene. The highest level of care provider remaining shall BC responsible for completing the patient care report and the Paramedic, Nurse Exception (Paramedic or EMT-I) or EMT-I shall complete the Present At Scene - Transfer of Care form which shall be attached to the patient care report. At a minimum, the Present At Scene - Transfer of Care form will include the following information: Date, Run #, Patient Name, Address, Age (or best estimate), nature of call, chief complaint, brief history, primary assessment, secondary assessment₉ any treatment given, and the name and level of care EMT the patient care was turned over to.

3) The highest level of care provider remaining with the patient is ultimately responsible for on-going assessment and to assure all patients care needs are met. The highest level of care provider remaining may delegate appropriate responsibilities to qualified EMS personnel at any time, but must be able to readily assume care if the patient's condition warrants.