Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 9 - TEXAS MEDICAL BOARD › Chapter 197 - EMERGENCY MEDICAL SERVICE › Section 197.5 - Authority for Control of Medical Services at the Scene of a Medical Emergency

Current through Reg. 49, No. 28; July 12, 2024
(a) Control at the
				scene of a medical emergency shall be the responsibility of the individual in
				attendance who is most appropriately trained and knowledgeable in providing
				pre-hospital emergency stabilization and transport.
(b) The prehospital provider on the scene is
				responsible for the management of the patient(s) and acts as the agent of the
				physician providing medical direction.
(c) If the patient's personal physician is
				present and assumes responsibility for the patient's care, the prehospital
				provider should defer to the orders of said physician unless those orders
				conflict with established protocols. The patient's personal physician shall
				document in his or her orders in a manner acceptable to the EMS system. The
				physician providing on-line medical direction shall be notified of the
				participation of the patient's personal physician.
(d) If the medical orders of the patient's
				personal physician conflict with system protocols, the personal physician shall
				be placed in communication with the physician providing on-line medical
				direction. If the personal physician and the on-line medical director cannot
				agree on treatment, the personal physician must either continue to provide
				direct patient care and accompany the patient to the hospital or must defer all
				remaining care to the on-line medical director.
(e) The system's medical director or on-line
				medical control shall assume responsibility for directing the activities of
				prehospital providers at any time the patient's personal physician is not in
				attendance.
(f) If an intervenor
				physician is present at the scene and has been satisfactorily identified as a
				licensed physician and has expressed his or her willingness to assume
				responsibility for care of the patient, the on-line physician should be
				contacted. Once the on-line physician is contacted, he or she is ultimately
				responsible for the care of the patient unless or until the on-line physician
				allows the intervenor physician to assume responsibility for the
				patient.
(g) The on-line physician
				has the option of managing the case exclusively, working with the intervenor
				physician, or allowing the intervenor physician to assume complete
				responsibility for the patient.
(h)
				If there is any disagreement between the intervenor physician and the on-line
				physician, the prehospital provider shall be responsible to the on-line
				physician and shall place the intervenor physician in contact with the on-line
				physician.
(i) If the intervenor
				physician is authorized to assume responsibility, all orders to the prehospital
				provider by the intervenor physician shall also be repeated to medical control
				for recordkeeping purposes.
(j) The
				intervenor physician must document his or her intervention in a manner
				acceptable to the local EMS.
(k)
				The decision of the intervenor physician not to accompany the patient to the
				hospital shall be made with the approval of the on-line physician.
(l) Nothing in this section implies that the
				prehospital provider can be required to deviate from standard
				protocols.