Who has the authority to modify or suspend a standing order during an emergency per ICEMA?

• A. The EMS Medical Director.
• B. The Medical Control physician or EMS Medical Director.
• C. The on-scene nurse.
• D. The hospital administrator.

Answer: (B)

In ICEMA, standing orders are issued under physician medical direction, so the authority to modify or suspend them in an emergency lies with the physician who provides that direction. The Medical Control physician or the EMS Medical Director has the clinical authority to alter the treatment plan in real time to protect patient safety and adapt to on-scene conditions. The on-scene nurse should follow established medical control guidance and obtain authorization for any deviation, but they do not independently suspend or change standing orders. The hospital administrator does not hold field clinical authority to modify patient care protocols.