Chapter 5. Medical Control of California Health And Safety Code >> Division 2.5. >> Chapter 5.
(a) The medical direction and management of an emergency
medical services system shall be under the medical control of the
medical director of the local EMS agency. This medical control shall
be maintained in accordance with standards for medical control
established by the authority.
(b) Medical control shall be within an EMS system which complies
with the minimum standards adopted by the authority, and which is
established and implemented by the local EMS agency.
(c) In the event a medical director of a base station questions
the medical effect of a policy of a local EMS agency, the medical
director of the base station shall submit a written statement to the
medical director of the local EMS agency requesting a review by a
panel of medical directors of other base stations. Upon receipt of
the request, the medical director of a local EMS agency shall
promptly convene a panel of medical directors of base stations to
evaluate the written statement. The panel shall be composed of all
the medical directors of the base stations in the region, except that
the local EMS medical director may limit the panel to five members.
This subdivision shall remain in effect only until the authority
adopts more comprehensive regulations that supersede this
The base hospital shall implement the policies and
procedures established by the local EMS agency and approved by the
medical director of the local EMS agency for medical direction of
prehospital emergency medical care personnel.
Advanced life support and limited advanced life support
personnel may receive medical direction from an alternative base
station in lieu of a base hospital when the following conditions are
(a) The alternative base station has been designated by the local
EMS agency and approved by the medical director of the local EMS
agency, pursuant to Section 1798.105, to provide medical direction to
prehospital personnel because no base hospital is available to
provide medical direction for the geographical area assigned.
(b) The medical direction is provided by either of the following:
(1) A physician and surgeon who is trained and qualified to issue
advice and instructions to prehospital emergency medical care
(2) A mobile intensive care nurse who has been authorized by the
medical director of the local EMS agency, pursuant to Section
1797.56, as qualified to issue instructions to prehospital emergency
medical care personnel.
(a) Authority for patient health care management in an
emergency shall be vested in that licensed or certified health care
professional, which may include any paramedic or other prehospital
emergency personnel, at the scene of the emergency who is most
medically qualified specific to the provision of rendering emergency
medical care. If no licensed or certified health care professional is
available, the authority shall be vested in the most appropriate
medically qualified representative of public safety agencies who may
have responded to the scene of the emergency.
(b) If any county desires to establish a unified command structure
for patient management at the scene of an emergency within that
county, a committee may be established in that county comprised of
representatives of the agency responsible for county emergency
medical services, the county sheriff's department, the California
Highway Patrol, public prehospital-care provider agencies serving the
county, and public fire, police, and other affected emergency
service agencies within the county. The membership and duties of the
committee shall be established by an agreement for the joint exercise
of powers under Chapter 5 (commencing with Section 6500) of Division
7 of Title 1 of the Government Code.
(c) Notwithstanding subdivision (a), authority for the management
of the scene of an emergency shall be vested in the appropriate
public safety agency having primary investigative authority. The
scene of an emergency shall be managed in a manner designed to
minimize the risk of death or health impairment to the patient and to
other persons who may be exposed to the risks as a result of the
emergency condition, and priority shall be placed upon the interests
of those persons exposed to the more serious and immediate risks to
life and health. Public safety officials shall consult emergency
medical services personnel or other authoritative health care
professionals at the scene in the determination of relevant risks.