Who has the highest authority on scene to determine which hospital a patient should go to?

In emergency medical services, the highest authority on scene regarding the destination hospital for a patient is typically the EMS captain present. The EMS captain has the leadership experience and comprehensive training needed to make critical decisions regarding patient care and transportation. This role includes assessing the situation, evaluating the patient's condition, and determining which facility will best meet their medical needs based on established protocols and available resources.

The paramedic in charge, while highly trained and capable of making important clinical decisions, may not have the overarching authority to determine destination protocols as the EMS captain does. The hospital supervisor does not typically have jurisdiction over decisions made in the field, particularly concerning the transport of patients. Additionally, while a patient’s family may provide valuable information regarding the patient’s preferences or history, they do not hold the formal authority to dictate which hospital is appropriate for care. Thus, the EMS captain is the key figure for such determinations on the scene.