EMTP Tactical Medical Refresher Course PWS.pdf

Performance Work Statement For

EMT/P Tactical Medical Refresher Course & Tactical Combat Casualty Care (TCCC)

5 - 13 January 2020

1.0. DESCRIPTION OF SERVICES. The contractor shall provide advanced medical instruction in both the classroom and field environment consisting of altitudes exceeding 6,000 ft. of elevation, winds exceeding 70 mph, temperatures ranging below 20 degrees Fahrenheit, and snow and ice conditions to allow for mountain medicine training. As well as all listed training facilities, medical facilitiesin paragraph 1.4. The contractor shall provide all equipment, tools, parts, transportation, personnel, labor, supervision, and management (no later than 5 Jan 2020). This training accomplish Combat Medical Training (CMT), Extreme Weather Medicine, EMT/P recertification, and TCCC training to Pararescuemen assigned to the 306th Rescue Squadron (306 RQS), Davis-Monthan Air Force Base, AZ.

1.1. Scope of Work: Provide advanced medical training and scenarios consistent with the requirements of rapid planning, coordination, and execution of a broad array of conventional and special operations oriented tasking as part of their organizational mission to conduct combat search and rescue by providing specially trained, combat ready, highly mobile forces. USAF Pararescue Forces employ in a variety of operations, across a wide spectrum of warfare areas, in the execution of this mission. Deliverables are Paramedic certificate with Continuing Education Unit (CEU) breakout, to include Advance Cardiac Life Support (ACLS), Pediatric Advance Life Support (PALS), Basic Cardiac Life Support (BCLS), Emergency Medicine Technician/Paramedic EMT/P while maintaining Combat Readiness, focus and training with Near Pier adversaries.

1.2. Basic Services: The contractor shall provide one (1) nine (9) day course of instruction for a maximum of 14 Guardian Angel (GA) personnel. The course of instruction shall include the latest medical procedures, casualty treatment, and triage techniques currently utilized throughout today’s evolving battle-space. Course of instruction shall combine classroom academics, along with procedure based training on Fresh Human Tissue (FHT) simulation aids IAW Pararescue Medical Handbook and NREMT/P standards. The course of instruction shall incorporate the tactical employment of medical treatment rendered by Pararescuemen through full mission profile (FMP) training and trauma lanes. The contractor shall provide realistic training scenarios in which personnel will have the ability to utilize all medical skills taught throughout the course.

These medical skills will follow the 7th edition Pararescue Medical Operations Handbook (October 2018). The vendor must also provide BLS/ACLS/PALS/EMT-P recertification. They will include human role players, vehicles to transport all support personnel and Unmanned Aerial Vehicles (UAV) with the capability to not only surveil but also fire weapons with non-lethal projectiles at training team members. Provide simunition (non-lethal training ammunition) and simunition adapted rifles for the TCCC scenarios. Must include patient assessment-drills, TCCC/MARCH PAWS- Ruck drills, Pararescue medication drills, Dive medicine, RSI checklist- RSI drill, Neuro Exam, Stroke lecture, Drill stations including Broselow tape/NG tube/Sterile technique & Foley/Junctional TQ & KTD, Eye trauma lecture, Travel/patrol medicine, MTP drills, Blood and blood products lecture, Fluid resuscitation, Eldon card practice, Transfusion drill, Mental health lecture, PTSD lecture, Optimizing performance lecture, Pediatrics lecture, Obstetrics lecture, Pilot ejection injury lecture, helicopter injuries, Splinting and immobilization drills, travel and patrol medicine, Prolonged field care lecture and scenarios, vents and monitor lecture with hands on training, TCCC training, TBI chest trauma lecture, Abdominal/pelvic trauma lecture, extremity trauma and amputations lecture, and Hemorrhagic shock lecture. Upon completion of the nine-day course, participants will have met the requirements necessary for Pararescue Medical Refresher (PJ25, Table 5.1 and Para 5.2.4.15, AFI 10-3502). The contractor shall provide medical equipment and supplies to include all items listed in 1.5.6.

1.2.1. Fresh Human Tissue Training (FHT): The vendor must be able to provide FHT for 14 students. The training will include no less than seven (7) FHT units. Each student must be able to perform and pass all of the training listed below to the National Registry Emergency Medicine Technician/Paramedic (NREMT/P) standard:

1. Lateral canthotomy

2. Intubation- DL, Video, bougie

3. Surgical Airway

4. Thoracic- ND, finger and tube thoracostomy, sub clavicles and packing

5. Leg fasciotomy

6. Escharotomy incisions

7. Field Amputations

8. IOs- sternal, humeral head, tibial, iliac crest

9. Wound Care- debridement, packing, drains, closure

10. Suprapubic bladder aspiration

1.2.2. Trauma Lanes Training/Mass Casualty Drill Training: The vendor must be able to provide trauma lanes/mass casualty training for 14 students. Scenarios must include:

1. TBI- blast

2. Chest Trauma

3. Acute Abdomen

4. Pediatric station

5. BKAs combat shock

6. Eye- shrapnel

7. Femur fracture

8. Evisceration

9. Burn cases

10. Mass Casualty Incident drill

1.2.3. Prolonged Field Care Lab: The vendor must be able to provide prolonged field care lab based off of real world scenarios focusing on civilian and combat medical environments. The course of instruction will include the following topics and training:

1. Current concepts in Tactical Combat Casualty Care

2. Human anatomy review

3. Patient assessments

4. Mechanism of injury

5. Blast and burn injuries

6. Ocular trauma

7. Neck trauma

8. Chest trauma

9. Abdominal trauma

10. Crush injuries

11. Pediatric emergencies

12. Orthopedic emergencies

13. Hemorrhage control

14. Advanced/difficult airway emergencies

15. Respiratory emergencies

16. Shock

17. Environmental emergency considerations

18. Patient packaging

19. Critical care transportation

20. Intravenous and intraosseous fluid therapy

21. Improvised and field expedient medicine

22. Sick call medicine

23. Patient handoff

24. Updates to the Pararescue Medical Operations Handbook (October 2018)

25. FHT Training

1.3. Contractor Qualifications: The vendor’s instructors must have intimate knowledge of Pararescue operations and skill sets, and tactical medical applicability to that mission. Vendor must have experience in training U.S Military Special Operations and Joint Forces, with proficiency in prolonged field care, Mass casualty scenarios, Fresh Human Tissue training, and buddy blood transfusions. They must also possess the following Certifications/Licenses:

1. FAA/UAV Certification

2. IFMGA/AMGA/SPRAT

3. NREMT-P certification or higher

1.4. Contractor Facility and Environmental Requirements: The vendor must provide facilities that can support a fresh human tissue lab for 14 students, tactical TCCC, mass casualty scenarios, areas for prolonged field care, and include a body of water in the immediate area.

1.4.1. FHT Facility: Vendor will provide the following:

1. Fresh Human Tissue lab with at least 30 sq. ft. per student or 420 sq ft.

2. A lab with computer screens at every table, updated ventilation and lighting systems

3. Private & dedicated dressing areas and locker rooms.

4. An adjacent Technology Enabled Active Learning classroom.

5. A lab with room for 30 students and faculty to work with high-resolution diagnostic imaging, computer screens at each of at least 14 dissection tables, and additional classroom and work spaces to support active and group learning.

1.4.2. Full Mission Profile Requirements: Vendor will provide the following:

1. Multiple shooting ranges with distances from 25yd. to 300 yds.

2. Ranges that can accommodate 270 degree fields.

3. Indoor 25 yd shooting range.

4. A Tactical Training Area that has multiple rooms, hallways, internal and external doorways, internal and external stairs and a catwalk, allowing a variety of scenarios for active shooter, force on force and tactics training.

5. At least three breaching doors including a Pry breaching door to be used with halligan tool or pry tool, a Ram breaching door to be used with a standard Ram, and a shotgun breaching door to be used with a shotgun and frangible 12 gauge slugs.

6. Minimum 15 foot deep subsurface water training area to be used for water recovery and shallow water drowning procedures.

1.4.3. Local Medical Facilities: Vendor will provide access to the following:

1. Level 1 trauma centers

2. Pediatric Level 1 trauma centers

1.4.4. Environmental Considerations: Must provide an environment that will have altitudes exceeding 6,000 ft. of elevation, winds exceeding 70 mph, temperatures ranging below 20 degrees Fahrenheit, and snow and ice conditions. These environments provide realistic deployment locations as well as allow the students to conduct high altitude medicine procedures such as High Altitude Pulmonary Edema (HAPE), Altitude Mountain Sickness (AMS), and High Altitude Cerebral Edema (HACE). As well as provide the necessary environment to conduct cold weather treatments in a realistic extreme environment where the injuries would occur.

1.5. Contractor Material Requirements:

1.5.1. Contractor shall provide all medical supplies required for training noted in 1.5.6.

1.5.2. All simulation aids must be properly and legally procured.

1.5.3. All training shall adhere to applicable testing for Hepatitis B, Hepatitis C and HIV and any other communicable diseases as required by state law and institutional policy, and the contractor shall provide relevant information about the results of testing for communicable diseases to the 306 RQS point of contact. All personnel who come in contact may shall be made aware of the positive test result and maintain necessary precautions to prevent disease transmission.

1.5.4. All training simulation aids disposal must be in a manner consistent with donor intent and legal requirements.

1.5.5. Problems related to the conduct involving CMT use of human simulation aids must be promptly reported to the 306 RQS point of contact and the Contracting Officer and in accordance with section 1.5.3 of this PWS. Examples of problems include, but are not limited to: loss of confidentiality, breach of security, significant deviation from the approved protocol, failure to comply with state laws and/or institutional policies and public relations issues.

1.5.6. The vendor will provide all materials necessary to accomplish the itemized skills detailed in sections 1.2.1., 1.2.2., & 1.2.3. for 14 students, four times each. Medical items required for listed events to meet NREMT and the Pararescue medical handbook are listed below.

MASSIVE HEMMORAGE:

1. Gen 7 Combat Application Tourniquet

2. Hemostatic Gauze

3. Compressed Gauze

4. Ace Wrap 3 inch

5. Combat Pressure Dressing

6. Coban

7. Junctional Tourniquet: provided by contractor for reuse in course

8. Pelvic Binder

AIRWAY:

1. Nasal Pharyngeal Airway

2. 6.0 Endotracheal Tubes Cuffed

3. Bougie

4. Supraglottic Airway

RESPIRATION:

1. 14 Gauge x 3.25 inch Needle Decompression

2. Chest Seal Non-Ventilated

3. Chest Tube

4. Chest Tube 1 way valve

5. Bag Valve Mask

CIRCULATION:

1. 500 ml 0.9 % Normal Saline

2. IV Pressure Infuser

3. Normal Saline Flush Syringes (10cc)

4. 18 Gauge IV Catheter

5. 20 Gauge IV Catheter

6. 2x2 Gauze

7. Alcohol Swabs

8. IV drug port

9. IV stabilizing dressing

10. 10Drop IV Tubing

11. 20,23 Gauge Drug Needles

12. Syringes 3cc,5cc,10cc

13. 2 and 3 inch Medical Tape

14. Y-Tubing: provided by contractor for reuse in course

15. Brown Manual Intraosseous needle 7 Site access

16. Intraosseous Needle Blue

17. Sharps Shuttle

HYPOTHERMIA:

1. Space Blanket Hypothermia

WOUNDS:

1. Surgical/ Suturing Kit: provided by contractor for reuse in course

2. Medical Stapler

3. Suture Needle and Thread 1-0,3-0

SPLINTING:

1. Rigid/ Flexible Splint

2. Triangle Bandage

ADMIN:

1. Durable Black Nitrile Gloves M, L, XL

2. Scalpel

3. Pt Treatment Cards DD Form 1380

4. Permanent Marker Fine / Ultra Fine

5. Trauma Shears

6. Bone Saw

1.6. Deliverables

1.6.1. On the final day of instruction, a certificate of completion for each student passing the course shall be provided, along with documentation outlining the number of continuing medical education (CME) hours earned throughout the course as well as BLS/ACLS/PALS/EMT-P recertification filed and submitted to NREMT.

1.6.2. A comprehensive after action report (AAR) of attending personnel’s performance and a summary report of all activities/training shall be submitted to the 306 RQS point of contact in electronic format no later than 30 days after the final training day. A brief description of the course activities and a brief description of the contractor’s involvement shall be included.

1.7. Applicable Documents and Reference. The contractor shall comply with the following:

1.7.1 Revised Uniform Anatomical Gift Act (UAGA), drafted by the National Conference of Commissioners of Uniform State Laws, 2006.

1.7.2 Laws or regulations applicable to the states and U.S. territories that govern the use of subject CMT activity and curriculum simulation aids.

1.7.3 Pre-Hospital Trauma Life Support/Tactical Combat Casualty Care (PHTLS/TCCC) protocols as established by the American College of Surgeons Committee on Trauma, the National Association of Emergency Medical Technicians.

1.8. Schedule

DAY:

1. Monday

0800-1600 TCCC, MARCH PAWS

2. Tuesday

0800-1600 TCCC scenarios/PHTLS/ACLS

3. Wednesday 0800–1600 Pharmacology, BLS/ACLS/PALS

4. Thursday

0800–1600 Buddy Blood Transfusion, Fluid resuscitation, Eldon card practice

5. Friday 0800-1600 Transfusion drills on Fresh Human Tissue Lab/Canine Medicine

6. Saturday

0800-1600 Prolonged Field care Lab

7. Sunday 0800-1600 Trauma Lanes, TBI, Thoracic Trauma, Abdominal, etc.

8. Monday

0800-1600 Patient Assessment Drills, Dive medicine

9. Tuesday 0800-1600 Mass Casualty/Full Mission Profile

1.9. Required staffing: Vendor must provide NREMT required instructor ratio per training event to maintain the required instructor to student ratio. In addition the instructor staff must collectively possess all qualifications and experience to meet all the NREMT requirements and listed training above

2.0. GENERAL INFORMATION

2.1. Licenses and Permits. The contractor shall, without additional expense to the Government, obtain any necessary licenses and permits, and comply with any Federal, State, and local laws, codes and regulations applicable to the performance work statement. The contractor shall provide proof of such applicable licenses and permits upon submittal of their proposal and at any time upon request by the Government. The contractor shall submit any applicable certifications.

2.2. Contractor Personnel

2.2.1. Contract Manager. The contractor shall provide a contract manager, and at least one alternate contract manager, who shall be responsible for the performance of the work.

The names and phone numbers of the contract managers, shall be designated in writing and submitted to the 306 RQS point of contact and Contracting Officer prior to the contract start date. The contract manager or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract and have contract authority to provide the services and obligate the contractor.

2.2.2. The contractor shall not employ persons for work on this contract if such employee is identified as a potential threat to the health, safety, security, general well-being, or operational mission of the installation and its population.

2.2.3. The contractor shall not employ any person who is an employee of the US Government if employing that person would create a conflict of interest. Additionally, the contractor shall not employ any person who is an employee of the Department of the Air Force, either military or civilian, unless such person seeks and receives approval according to Department of Defense (DoD) Regulation 5500.7-R, Joint Ethics Regulations (JER). The contractor shall not employ any person who is an employee of the Department of the Air Force if such employment would be contrary to the policies in Air Force Instruction 64-106, Contractor Labor Relations Activities.

2.2.4. Organizational Conflict of Interest. If the contractor provides an agency with support in preparing for and/or conducting acquisitions under this contract, the agency may require that the contractor sign an organizational conflict of interest statement in which the contractor (and any subcontractors or teaming partners) agree not to submit any proposal or provide any support to any firm which is submitting (as prime or subcontractor) any proposal for any solicitation resulting from the work under this contract. The agency and contractor shall strive to identify and report situations in which an organizational conflict may result. All potential conflict of interest situations shall be handled in accordance with the Federal Acquisition Regulation, Subpart 9.5.

2.2.5. Applicable Documents and Reference. The contractor shall insure compliance with: Revised Uniform Anatomical Gift Act (UAGA), drafted by the National Conference of Commissioners of Uniform State Laws, 2006.

2.2.5.1. Specific Contractor Requirements: Provide safe and operable training locations & facilities.

3.0. Place of Performance. The contractor shall provide all facilities meeting all of the criteria stipulated in Section 1.4 and all subsections. The Government will provide transportation and lodging for all Government attendees.

3.1. Period of Performance. The period of performance for training is Jan 5-13, 2020.

3.2 Privacy and Security

3.2.1 Privacy Act. If work on this project requires that personnel have access to Privacy Act Information, contractor personnel shall adhere to the Privacy Act, Title 5 of the U.S.

Code, Section 552a and applicable agency rules and regulations.

3.2.2 Security. Personnel shall adhere to the provisions against sensitive information and/or information that effects national security under 18 U.S.C., Sec 1905 ("Trade Secrets Act") and 5 U.S.C. Secs 552(b)(1) and (b)(4), which prohibit the release of sensitive information trade and national security information, in addition to the provisions under Executive Orders 13526 and 12356 ("National Security Information)

3.3. 306 RQS Point of Contact. The point of contact is TSgt Mark Lillmars and he can be reached at mark.lillmars.1@us.af.mil or by phone at (570) 854 3847. With the alternate POC of MSgt Robert Hutchison and he can be reached at robert.hutchison.1@us.af.mil or by phone at (520) 400 3864.

mailto:mark.lillmars.1@us.af.mil mailto:robert.hutchison.1@us.af.mil