S06 Attachment A CCT Capabilities Confirmation 12.9.2020.docx

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. Prospective offerors must sign and return this form confirming they can meet these criteria for CCTs ordered under this contract.

CCT team (of at least two individuals) must be critical care specialty certified and consist of at least one licensed RN, APRN, physician, or PA, with the other member being a paramedic and should be able to provide the following services:

· Advanced patient assessment

· Cardiac monitoring

· Airway management including medication assisted intubation with paralytics, video larynogoscopy

· Ventilator management

· CPAP, BIPAP, high flow nasal cannula therapy

· Advanced pharmacology *see lists below

· IV Pump management and medication titration

· If pumps are not compatible with VA IV tubing, CCT will provide their own tubing and switch lines over prior to transport

· Blood product administration

· Central line access and maintenance

· Femoral sheath maintenance

· Chest tube management

· Doppler assessment

· Ventricular assist device management (LVAD, RVAD, BiVAD, PVAD)

· Invasive hemodynamic monitoring (Arterial Line, CVP, PAP/Swan Ganz Catheter)

· Transcutaneous, transvenous, and epicardial pacing *with facility equipment

· Intra-aortic balloon pump management

· Impella management

· External ventricular drain management

· Intracranial pressure monitoring

· Continuous bladder irrigation

· Portable suction

Pharmacology CCT must carry, and have the ability to calculate and independently administer, medications applicable to the critical care environment and covered in protocols, guidelines, or standing orders. This includes:

· Vasoactive agents

· Paralytics

· Anxiolytics/Sedatives

· Anti-inflammatory medications/Steroids

· Anticonvulsants

· Opioids and other analgesics

· Nebulized medications (alpha and beta 2-adrenergic agonists)

· Antiemetics

· ACLS medications: Epinephrine, Lidocaine, Atropine, Anti-arrhythmic

· Prostaglandin, Surfactant

*Must be able to administer (at a minimum) Acetylcysteine (Acetadote, Mucomyst) Albuterol, ipratropium Amiodarone Antibiotics Blood products D50 Diltiazem (Cardizem) Dobutamine Dopamine Esmolol Epinephrine drip Electrolytes (Potassium, Magnesium, Calcium) Fentanyl (Sublimaze) Furosemide (Lasix) Heparin Hyperalimentation (TPN and lipids) Insulin IVFs (LR, NS, Dextrose-containing fluids, hypertonic saline) Ketamine Labetalol Lidocaine Lorazepam (Ativan) Mannitol Midazolam (Versed) Milrinone Morphine Naloxone Nicardipine (Cardene) Nitroglycerin (NitroStat, Nitro-Dur, Nitro-Bid) Norepinephrine (Levophed) Octreotide (Sandostatin) Ondansetron (Zofran) Pantoprazole (Protonix) Phenylephrine (Neo-Synephrine) Potassium Chloride Propofol Sodium Bicarbonate tPA (Alteplase) Vasopressin (Pitressin) Vitamin K (Phytonadione)

Equipment:

Monitoring Capabilities:

Continuous 12-lead EKG monitoring 2-Temperature Monitoring Automatic Non-Invasive Blood Pressure monitoring Capnography Pulse oximetry Arterial line monitoring Cardiac defibrillation, cardioversion, and transcutaneous pacing capabilities Glucometer Stethoscopes

Respiratory Support:

Multimode transport ventilator Ability to endotracheally intubate (various sized endotracheal tubes) Video assisted laryngoscopy Supraglottic airways Oxygen supply Compressed air Portable/reserve oxygen Vehicle-powered and portable suction

Hemodynamic Support Equipment:

Cardioversion/defibrillator with transcutaneous pacing capability and pads IABP if IABP counterpulsation is part of scope of practice

· IABP must be configured for secure placement in vehicle with certified manufactured mount and have battery power capability allowing for continuous counterpulsation between vehicle and hospital Adequate adjuncts for ECMO and VADs

· Power delivery, invasive line monitoring, medication formulary, infusion pumps, certified manufacturer mounts Ability to administer multiple concurrent medications via IV pump IV placement equipment via peripheral, intraosseous, and/or central IV access for med and fluid administration Pressure infusion device

Other:

Ability to maintain vehicle cabin temperature within prescribed limits for pharmaceuticals and blood Communications equipment