Attachment D-2 Critical Care Transport Capabilities Confirmation.pdf
PDF 44 KB Posted
- Solicitation number
- 36C25624R0033
About this file
This document is an attachment to a federal solicitation outlining critical care transport capabilities required by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. Offerors must confirm they can supply the extensive drug and equipment lists provided for critical care ground ambulance transports, including medications, monitoring equipment, pumps, and supplies up to tier III critical care levels. The related solicitation is for ground ambulance and patient transportation services in Central Arkansas, solicitation number 36C25624R0033.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25624R0033 Solicitation Amendments and Changes Dated 01-23-2024.xlsx | XLSX spreadsheet | |
| 36C25624R0033_Solicitation_LR_Ambulance Rev1 01-23-2024.docx | DOCX document | |
| 36C25624R0033 Amendment 0001.pdf | ||
| Attachment D-1 Performance Work Statement LR Rev 1 01-23-2024.docx | DOCX document | |
| 36C25624R0033_Solicitation_LR_Ambulance.docx | DOCX document | |
| Attachment D-3 Business Associate Agreement.docx | DOCX document | |
| Attachment D-4 Wage Determinations.pdf | ||
| Attachment D-1 Performance Work Statement LR.docx | DOCX document |
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Text version
Attachment D.2
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) Furosemide (Lasix) Heparin Hyperalimentation (TPN and lipids) Insulin Labetalol (Trandate) Lidocaine Lorazepam (Ativan) Magnesium Sulfate Mannitol Midazolam (Versed) 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
*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. *
Zoll X Series Critical Care Monitor Capabilities:
Continuous 12-lead EKG monitoring 2-Temperature Monitoring Automatic Blood Pressure Capnography 2 arterial lines monitoring
File details come from the government source that posted it. Updated .