SECTIONS 1798-1798.6

1798.  (a) The medical direction and management of an emergencymedical services system shall be under the medical control of themedical director of the local EMS agency. This medical control shallbe maintained in accordance with standards for medical controlestablished by the authority. (b) Medical control shall be within an EMS system which complieswith the minimum standards adopted by the authority, and which isestablished and implemented by the local EMS agency. (c) In the event a medical director of a base station questionsthe medical effect of a policy of a local EMS agency, the medicaldirector of the base station shall submit a written statement to themedical director of the local EMS agency requesting a review by apanel of medical directors of other base stations. Upon receipt ofthe request, the medical director of a local EMS agency shallpromptly convene a panel of medical directors of base stations toevaluate the written statement. The panel shall be composed of allthe medical directors of the base stations in the region, except thatthe local EMS medical director may limit the panel to five members. This subdivision shall remain in effect only until the authorityadopts more comprehensive regulations that supersede thissubdivision.1798.2.  The base hospital shall implement the policies andprocedures established by the local EMS agency and approved by themedical director of the local EMS agency for medical direction ofprehospital emergency medical care personnel.1798.3.  Advanced life support and limited advanced life supportpersonnel may receive medical direction from an alternative basestation in lieu of a base hospital when the following conditions aremet: (a) The alternative base station has been designated by the localEMS agency and approved by the medical director of the local EMSagency, pursuant to Section 1798.105, to provide medical direction toprehospital personnel because no base hospital is available toprovide 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 issueadvice and instructions to prehospital emergency medical carepersonnel. (2) A mobile intensive care nurse who has been authorized by themedical director of the local EMS agency, pursuant to Section1797.56, as qualified to issue instructions to prehospital emergencymedical care personnel.1798.6.  (a) Authority for patient health care management in anemergency shall be vested in that licensed or certified health careprofessional, which may include any paramedic or other prehospitalemergency personnel, at the scene of the emergency who is mostmedically qualified specific to the provision of rendering emergencymedical care. If no licensed or certified health care professional isavailable, the authority shall be vested in the most appropriatemedically qualified representative of public safety agencies who mayhave responded to the scene of the emergency. (b) If any county desires to establish a unified command structurefor patient management at the scene of an emergency within thatcounty, a committee may be established in that county comprised ofrepresentatives of the agency responsible for county emergencymedical services, the county sheriff's department, the CaliforniaHighway Patrol, public prehospital-care provider agencies serving thecounty, and public fire, police, and other affected emergencyservice agencies within the county. The membership and duties of thecommittee shall be established by an agreement for the joint exerciseof powers under Chapter 5 (commencing with Section 6500) of Division7 of Title 1 of the Government Code. (c) Notwithstanding subdivision (a), authority for the managementof the scene of an emergency shall be vested in the appropriatepublic safety agency having primary investigative authority. Thescene of an emergency shall be managed in a manner designed tominimize the risk of death or health impairment to the patient and toother persons who may be exposed to the risks as a result of theemergency condition, and priority shall be placed upon the interestsof those persons exposed to the more serious and immediate risks tolife and health. Public safety officials shall consult emergencymedical services personnel or other authoritative health careprofessionals at the scene in the determination of relevant risks.