On a 911 response, which role is primarily responsible for directing patient care decisions in the field?

• A. Dispatcher
• B. The physician on call
• C. The paramedic
• D. The nurse in the hospital

Answer: (C)

Field EMS care decisions are directed by the paramedic. With advanced training in assessment, airway management, medications, and procedures under medical control, the paramedic evaluates the patient on scene, applies protocols, initiates treatment, and decides on transport. The dispatcher coordinates the response but doesn’t make treatment decisions in the field. The physician on call provides medical direction remotely, but the day-to-day on-scene decisions are made by the paramedic. The nurse in the hospital isn’t present in the field. This combination makes the paramedic the primary decision-maker for field patient care.