As an ED nurse, I rely heavily on the EMS provider’s documentation.  I believe the current and proposed EMS regulations regarding Patient Care Documents (12VAC5-31-1140) underestimates the importance of this document.  This record can assist with crucial decisions regarding the care of that patient.  It is part of the whole picture of the care and or treatment given to a patient prior to arrival at the hospital.  It helps with estimating time of onset of symptoms with suspected stroke, the time that trauma occurred, and the medications/treatments administered just to mention a few things.  Many times a quick patient report is given hitting the highlights but leaving out important details that may be crucial when deciding the patient's plan of care.  EMS is an essential part member of the health care team and their documentation is invaluable.  They are the first set of eyes to see a patient and their condition/environment.  To arrive 24 hours after the fact is a great disservice to the patient and, frankly, is after the fact.  The lack of a patient care document upon arrival to the hospital appears of unprofessional and I know EMS providers deserve far more credit than that!