Attachment A.docx
DOCX document 19 KB Posted
- Attached to
- V225--Special Mode Ambulance Services Federal contract opportunity
- Solicitation number
- 36C24625R0004
About this file
This is a Critical Care Transport (CCT) capabilities confirmation form (Attachment A) for ambulance service providers bidding on a Department of Veterans Affairs contract. The document outlines the required drugs and equipment that providers must be able to transport for critical care patients up to Tier III level.
The requirements include the capability to transport and administer 28 specific medications (including various cardiac drugs, antibiotics, and sedatives) and critical equipment such as chest tubes, portable mechanical vents, CVP lines, and Swan-Ganz lines. Providers must have SmartPump capability for up to 6 IV drips and Zoll X Series Critical Care Monitor capabilities including continuous 12-lead EKG monitoring, temperature monitoring, automatic blood pressure, capnography, and arterial lines monitoring. The form requires the company name and signature of a representative confirming they can meet these CCT criteria.
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| WD - Hampton - 2015-4341 - Rev 29 - 23 Dec 2024.pdf | ||
| Attachment B.docx | DOCX document | |
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| 15-4407_Dare Hyde Tyrrell Washington.txt | TXT text file | |
| 15-4331_ king and queen middlesex.txt | TXT text file | |
| 36C24625R0004_1.docx | DOCX document | |
| 15-4327_northhampton.txt | TXT text file |
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Text version
Attachment A
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.
| 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 | ||
| Diltiazem (Cardizem) | Swan-Ganz line | ||
| Dobutamine | SmartPump Capability: up to 6 IV drips |
Dopamine Fentanyl (Sublimaze) *Any pump(s) capable for up to and including 6 infusion lines or IV drips as required by the patient. If the pumps are not compatible with VA supplied IV tubing, the contracted ambulance would need to provide their own tubing and be able to switch the tubing over prior to transport. *
Furosemide (Lasix) Heparin Hyperalimentation (TPN and lipids) Insulin Labetalol (Trandate) Lidocaine Lorazepam (Ativan) Magnesium Sulfate Mannitol Midazolam (Versed)Zoll X Series Critical Care Monitor Capabilities:
Continuous 12-lead EKG monitoring 2-Temperature Monitoring Automatic Blood Pressure Capnography 2 arterial lines monitoring
Milrinone (Primacor) 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 .