Who is responsible for your patient?

[systemet]

Legally speaking, you are responsible unless that RN is going to assume care throughout the whole patient care process. (unlikely story). I have seen this first hand on a couple occasions and it has helped, but also has almost come close to biting me in the butt.

Granted, it's important that one person be in charge when the patient acutely decompensates and rapid corrective action is needed. I can't imagine a time when that's person's going to be an RN on a scene call.

The only times that immediately come to mind, are maybe working with a NICU / PICU transport team, where a lot of the time, my job has been to pass things around and deal with logistical problems. And perhaps doing an IFT with an RN escort to manage a balloon pump. And even in that situation, I've felt like the responsibility is divided. If there's an acute problem with the balloon pump, while I have some education, it's going to be the RN taking the lead. If there's an acute airway issue, that's going to be my problem to fix.

It's a team game. You have to be foolish to completely discount good information coming from another provider, especially if they have expertise in an area you don't.

I've heard of situations where non-MDs have offered help saying "I'm a doctor". No reasonable person is going to do this on a 911 call. No reasonable PhD in English literature or Molecular Genetics, and no reasonable DVM, etc. is going to do this. But there are plenty of unreasonable people in the world. The thing is, when someone approaches you and wants to take over care, you get to decide whether they do that. If you don't believe they're an MD, you can ask them to prove it. And if you can't reach a reasonable compromise, you can always call PD.

Almost all of these hypothetical situations are solved by calmly talking to people, showing respect, and then evaluating their responses with a little bit of critical skepticism. In most situations, this isn't that hard.

[Richard B the EMT]

Again, our medicolegal system is much less complex

I should pay attention to my own words, that another's local protocols can and will be different than MY local Protocols