Who has the ultimate authority for patient care at a mass-casualty incident?

The EMS medical director holds the ultimate authority for patient care at a mass-casualty incident due to their comprehensive training, knowledge, and responsibility in overseeing the medical aspects of emergency operations. This individual's role involves formulating protocols, ensuring that the care provided aligns with regulatory standards, and making critical decisions regarding patient treatment and resource allocation.

In a mass-casualty incident, it is essential to have a designated medical authority to coordinate care effectively. While other roles, such as the incident commander, are vital for operational management and resource deployment, the medical director specifically focuses on the clinical aspects of patient care, ensuring that the medical team adheres to established protocols and best practices.

The most experienced EMT may have valuable hands-on knowledge, but this role does not encompass the overarching authority needed for patient care decisions in a complex situation. Similarly, while the treatment officer plays an important role in managing the treatment area and directing teams, they operate under the guidance of the medical director. The incident commander oversees the entire incident scene, including logistics and personnel, but does not have the specific medical expertise necessary for making informed clinical decisions, which is the responsibility of the EMS medical director.