Donna C, if you werent on scene and have never worked in EMS, why are you making all of the assumptions? It may not be easy for you to understand. Like I stated earlier, decisions are made and sometimes patient conditions change which in turn changes what you have to do. It doesn't have to be an automobile accident for someone to need a trauma center. Maybe if you were there or knew a little more about the situation, you would understand a little better. Until then, dont put EMS, Fire or PD under a microscope about something you aren't sure of.
As fas as "Who is in charge", decisions are mostly made by everyone involved. Usually the medic with and air crews if they are on scene. Yes, someone has primary patient care, but most of the times communication is made between everybody and a quick decision is made.
The "Golden Hour" is time from the incident to DEFINITIVE CARE. DEFINITIVE CARE = Surgery
As far as the statement of "if you are carried in via ambulance, you will be seen a lot more quickly than a walk in". . . WRONG. That is what triage is for. Not all ambulance patients go straight to a room. That is another common misperception of the general public.