36C25220Q0044-002.pdf
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- Solicitation number
- 36C25220Q0044
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This document includes a critical care transport capabilities confirmation form and information on a related federal contract opportunity for ambulance services. The critical care transport capabilities confirmation form requires ambulance service providers to confirm they can supply certain drugs, equipment, and monitors as needed for critical care patient transports. The related federal contract opportunity is solicitation number 36C25220Q0044 to provide ambulance services including basic life support, advanced life support, and critical care transports at the Edward J Hines VA Hospital in Illinois. The contract will have a five-year ordering period with a firm fixed price and is set aside for priority of veteran-owned small businesses and service-disabled veteran-owned small businesses. The Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 12 is the contracting agency.
36C25220Q0044 S02 Attachment A CCT Capabilities Confirmation.pdf
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25220D0008-000.docx | DOCX document | |
| 36C25220Q0044-0002000.docx | DOCX document | |
| 36C25220Q0044-0002000.docx | DOCX document | |
| 36C25220Q0044-0001000.docx | DOCX document | |
| 36C25220Q0044-0001000.docx | DOCX document | |
| 36C25220Q0044-001.docx | DOCX document | |
| 36C25220Q0044-003.pdf | ||
| 36C25220Q0044-002.pdf | ||
| 36C25220Q0044-001.docx | DOCX document | |
| 36C25220Q0044-003.pdf | ||
| 36C25220Q0044-000.docx | DOCX document | |
| 36C25220Q0044-000.docx | DOCX document |
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Critical Care Transport Capabilities Confirmation
If a transport is classified as a Critical Care Transport (CCT) the offeror must be capable of transporting the drugs and/or equipment as required by the patient (listed below), up to and including Tier III if necessary, based on the EMS region the ambulance provider is functioning in. able to provide the drug supply and equipment listed below. Prospective offerors must sign and return this form confirming they can meet these criteria for CCTs ordered under this contract.
Drug Supply List: Equipment List:
Acetylcysteine (Acetadote, Mucomyst) Chest tubes Amiodarone (Cordarone) Portable mechanical vents; including CPAP Antibiotics All VADs Blood and Blood Products CVP lines Diltazem (Cardizem) Swan-Ganz line Dobutamine SmartPump Capability: up to 6 IV drips Dopamine *Any pump(s) capable for up to and Fentanyl (Sublimaze) including 6 infusion lines or IV drips as Furosemide (Lasix) required by the patient. If the pumps are Heparin not compatible with VA supplied IV tubing, Hyperalimentation the contracted ambulance would need to (TPN and lipids) provide their own tubing and be able to Insulin switch the tubing over prior to transport.* Labetalol (Trandate) Lidocaine Zoll X Series Critical Care Monitor Capabilities:
Lorazepam (Ativan) Continuous 12-lead EKG monitoring Magnesium Sulfate 2-Temperature Monitoring Mannitol Automatic Blood Pressure Midazolam (Versed) Capnography Milrinone (Primacor) 2 arterial lines monitoring Nicardipine (Cardene) Nitroglycerin (NitroStat, Nitro-Dur, Nitro-Bid) Norepinephrine (Levophed) Octreotide (Sandostatin) Ondansetron (Zofran) Pantoprazole (Protonix) Phenylephrine (Neo-Synephrine) Potassium Chloride Propofol Sodium Bicarbonate Vasopressin (Pitressin) TPA* (pending)
I hereby confirm that can meet the criterion for Critical Care Transports.
(Company Name)
Signature of company representative Date
File details come from the government source that posted it. Updated .