When multiple patients are present, who is typically responsible for establishing command?

In situations involving multiple patients, establishing command is crucial for effective management of the scene and coordination of care. The senior EMR is typically responsible for establishing command because this individual often has the necessary experience and training to assess the situation, provide guidance to other responders, and make critical decisions regarding patient care and resource allocation.

The senior EMR's role includes overseeing the overall management of the incident, evaluating the needs of the patients, calling for additional resources if necessary, and ensuring that team roles are clearly defined. This position also involves communication with other emergency services and the establishment of a triage system to prioritize patient care based on the severity of their conditions.

While the most experienced EMR or the first responder may have valuable input and leadership qualities, their designation may not formally provide them with the authority to command the scene. The nearest paramedic, although they may have advanced medical skills, may not be the first in a training or supervisory role on the emergency medical scene. The senior EMR's responsibility aligns with standard practices for emergency response coordination and management.