Originally Posted by Gallium
I see you've completely missed my point. Additionally, there are instances where standing orders and new protocols have superseded "medical direction". In my state things flow down from the state level, and in many instances (fire in particular) the state and the rest of the nation takes cues from NY City.
I asked a question about ALS<>IV lines.
It just doesn't work like that. Who do you think orders those "standing orders." Legislators? No. Like I've tried to explain, it's a physician acting as a medical director. The state gives EMS it's scope of practice. Local physicians allow EMS to work within that scope of practice as an extension of their medical license. It's quite simple, but I just can't seem to get this through.