Jeff Clawson, M.D.
At the core of this old Journal article is the argument regarding if an en route responder, whether EMT, paramedic, or captain, should be allowed to determine, or even change, the response mode (HOT vs. COLD) of a call after it is dispatched. Maybe 40 years ago, before any evaluation or determination of the call condition and/or situation was made by dispatch, this might have been okay. However, as we know now, the emergency dispatcher, as a truly professional calltaker, is the one who knows more about the call than anyone else involved, especially before anyone gets to the scene to reassess.
In essence, it is easily argued that the EMD is actually the initial “scene commander,” and clearly remains so, not only until someone else gets to the scene, but until the scene can be accurately assessed. This is simply based on the fact that no one can know more about the scene, per the caller, than the emergency dispatcher—period. The response [by Dr. Jeff Clawson] to the agency involved helped to set the record, and standard of care and practice, straight on this one many years ago.
No one has effectively challenged this rationale, or has even tried, since! …