Attatchment D.2 CCT Confirmation.docx
DOCX document 19 KB Posted
- Solicitation number
- 36C25624R0039
About this file
This document is an attachment confirming capabilities for critical care transports under a federal ground ambulance contract opportunity with the Department of Veterans Affairs. The attachment lists drugs, equipment, and monitor capabilities required for critical care transports classified as Tier III, which prospective offerors must sign confirming they can provide. Required drugs include various antibiotics, blood products, cardiac medications, and sedatives. Required equipment includes chest tubes, portable ventilators, central venous pressure lines, and any pumps capable of six infusion lines as needed by the patient. Offerors must also have a Zoll X Series Critical Care Monitor to monitor EKG, temperatures, blood pressure, capnography, and two arterial lines. The related federal contract opportunity is for ground ambulance services at the Alexandria, Louisiana VA Medical Center with solitation number 36C25624R0039 issued by Veterans Health Administration VISN 16.
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Other files
| File | Type | Posted |
|---|---|---|
| Attatchment D.1 PWS Ground Ambulance AVAHMC.pdf | ||
| Attatchment D.3 BAA Template Aug 2023.pdf | ||
| Attatchment D.4 WD - Combined Areas - for AVAHMC.pdf | ||
| 36C25624R0039 RFP.docx | DOCX document |
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Text version
Attachment D.1
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 |
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