My colleague and I received an emergency call at 3:40 a.m. regarding reports of a traffic collision involving two vehicles. Once on scene, it was confirmed to be a high-speed collision. I received a brief handoff from the lead paramedic who was caring for a patient who had suffered serious deceleration injuries due to the mechanisms involved. The paramedic said: “The patient is mechanically stuck, we have to wait for the firefighters to free him.” Our priority at this stage was to prevent further deterioration of the patient and to promote his recovery through comfort, pain relief in addition to treatment of the various injuries he had suffered. I calculated that the firefighters would be there very soon, as the occupants of the other car involved were being extricated and loaded into waiting ambulances by members of the Hazardous Area Response Team (HART). ). I decided that this would be an appropriate time to lead a discussion within the group about how the extraction would take place. This reflection has enhanced my awareness of clinical leadership in the pre-hospital setting. FEELINGS The approach to the incident was extremely dangerous due to the road surface. being covered in various car components, furthermore, members of the public moved freely around the scene. Once there, I quickly realized that time was critical and that my paramedic colleague needed my help. I felt confident moving from passive follower to leader, which also allowed the paramedic to treat other injured people at the scene. Atwal & Caldwell, (2006)state”, being part of a multidisciplinary team requires many skills; this involves understanding not only one's own role but also that of other practitioners... middle of article......://www.hpc-uk.org/assets/documents/1000051CStandards_of_Proficiency_Paramedics.pdf. Last accessed November 27, 2012. Health Professionals Council (2007). Paramedic, competency standards. Available: http://www.hpc-uk.org/assets/documents/1000051CStandards_of_Proficiency_Paramedics.pdf. Last accessed November 2, 2012McCormick, S. (2003). Article 12. Major incidents, leadership and series summary and review. Journal of Emergency Medicine, 20(1), 70-74. doi:10.1136/emj.20.1.70 Quote from Lao Tzu: To lead people, walk alongside them... As for... (nd). Retrieved November 8, 2012, from http://www.goodreads.com/quotes/10627-to-lead-people-walk-beside-them-as-for-theSchmidt,B. (2011). How and why to debrief an incident. Available: http://www.firefighternation.com/article/incident-command-0/how-why-conduct-incident-debriefing. Last consulted on November 27 2012.