Responsibility of Care

Good morning!

The first thing to do would be to have a discussion with the PCP crew to determine what level of care is required and any foreseeable risks that need to be considered. Feel free to also reassess the patient for any changes. If all is taken in account and the patient only requires PCP AIV level skills for their care, then the AIV paramedic can treat and monitor. That said, it is perfectly acceptable for the ACP to attend in anticipation of potential patient changes or considerations of foreseeable risks that an ACP may likely need to treat for. Planning ahead in these situations is of course very important!

To help support this, here is an excerpt from the ALS-PCS on the topic of Responsibility of Care (page 10):

Each paramedic is equally responsible for patient care within their scope of practice. If the care exceeds a paramedics scope of practice, responsibility for that continued care shifts to the higher certified paramedic.

If there is any disagreement between paramedics, the Base Hospital physician may be contacted. It is expected that when an intervention has been performed, the paramedic most appropriate for that intervention will remain responsible for the patient.

The risks to the patient during transport should be assessed and discussed prior to transferring care from a higher to lower level of paramedic (e.g.: ACP to PCP), paramedics must alert the highest-level paramedic of any change of patient status at any time in the call.

Take care!

CEPCP