Special circumstances exist when the physician on-scene is associated with a helicopter rescue service. This policy involves on-scene encounters with a licensed physician who responds with the helicopter of a properly licensed helicopter rescue service approved to respond in the Monroe County area.

When a helicopter ambulance service known to be staffed by a practicing emergency medicine physician arrives on the scene of an emergent injury or illness, care of that patient will automatically be transferred from the Medical Control physician to the on-scene physician. All EMS personnel may take direction from that physician as long as all direction is consistent with Monroe County EMS Protocols. If the physician on-scene makes requests which are not consistent with Monroe County Protocol or appear to be in conflict with the best interest of the patient (s), the EMS personnel shall immediately contact the Medical Control physician to discuss the situation. At that time a direct physician to physician communication can be made. If no such conflicts take place, the EMS personnel shall contact the Medical Control physician as soon as possible with a patient report/update and to notify that a physician is on-scene. EMS will also notify Medical Control of the hospital destination, means of transport and ETA.

If the helicopter physician is not a practicing emergency medicine physician, EMS personnel will not automatically turn care over to that physician, or take direction from that physician. Under these circumstances, the Monroe County Medical Control physician should be contacted immediately and the case further discussed. Physician direction will then be determined on a case-by-case basis.

If no physician is on the responding helicopter, physician direction will be maintained by Monroe County Medical Control physician.

Any confusion or conflicts regarding physician authority and/or orders should be discussed on-line with Monroe County Medical Control immediately.