Medical Transport Levels
KCEAA has 4 levels of services offered for transports:
BLS-Basic Life Support- Offers 2 EMT’s-Emergency Medical Technicians
This type of service is needed when a patient is stable, requires no cardiac monitoring, can have a heparin lock and may or may not have oxygen. When this service is provided two EMT’s will transfer the patient.
ALS-Advanced Life Support- Offers a Paramedic and an EMT
This type of service is needed when a patient may be on maintenance IV fluid, oxygen and may require cardiac monitoring. They can also transport patients with Foley catheters and limited medications. They can transport patients requiring advanced cardiac life support.
C3IFT- Class 3 Interfacility Transport –A specially trained transport Paramedic and EMT
Class 3 Interfacility Transport service is needed when a patient requires monitoring and certain medications, blood/blood products/may have chest tubes, tracheostomies, Foley catheters and/or central lines/PICC lines. The biggest difference when determining the need for a C3IFT and CCT is the stability and complexity of the patient.
CCT-Critical Care Transport- CCT Offers a CCT-Registered Nurse, a CCT-Paramedic and an EMT
- This type of service is needed when a patient requires critical care monitoring and interventions. These patients will be unstable or have a high risk of becoming unstable and/or may have a high complexity. This is a very limited service and should only be utilized when necessary. We offer continuous nursing care from bedside to bedside. We have the latest in critical care equipment, including a specialized ventilator, CCT monitor, trans-venous pacer, IV pumps, medications, surgical airways, chest tubes, 12 lead EKG with fax transmission capability, Doppler, and invasive monitoring capability among others. We have the latest in critical care medications available in the treatment of the acutely ill or injured. These include vasoactive drugs, sedatives, paralytics, antibiotics, emergency medications, blood thinners, pain medications, antipyretics, respiratory medications, steroids, diuretics, volume expanders, osmotic diuretics, and many more.
- The only difference between aeromedical CCT and ground CCT is the mode of transport. All personnel are required to take a Critical Care Transport class which is 10 weeks long and requires clinical rotations. They must successfully pass a written and practical exam to obtain the extended scope of practice awarded by WVOEMS. They are very valuable resources but very limited and must be utilized appropriately.
When should you call for CCT or C3IFT?
- Does your patient have critical drips (Levophed, Dopamine, Dobutamine, Vasopressin, Nipride, Nitroglycerin) that need to be titrated?
- Does your patient have critical drips (Levophed, Dopamine, Dobutamine, Vasopressin,
- If the answer is yes then you should request CCT
- If the drip is not being titrated and the patient is stable then a C3IFT transport would be needed
- Is your patient receiving multiple units of blood, FFP, or other products?
- If the patient requires multiple transfusions then CCT should be requested
- If the patient is already receiving blood and requires no additional blood or blood products enroute then a C3IFT should be requested. A C3IFT Paramedic can monitor blood only and cannot initiate additional units of blood. It must be infusing a minimum of 15 minutes before departing the facility
- Is your patient in need of any specialized procedures or have they had any specialized procedures that require close observation?
- If yes then CCT should be requested
- Is there a high potential for complicated airway problems?
- If yes then CCT should be requested
- Our C3IFT Paramedics have been trained to manage patients with tracheostomies, chest tubes, Foley catheters and central lines
- Is your patient an active MI with continued pain or other complications?
- If yes then request CCT
- If the patient is pain free and is going for a scheduled cardiac catheter then a C3IFT request should be made
- Does your patient have extensive neurological problems or equipment that needs to be monitored?
- Request CCT
- If the patient is stable then request C3IFT
- Does your patient have an arterial line or a Swan-Ganz catheter?
- C3IFT paramedics can transport patients with arterial lines but they cannot monitor them.
- Request CCT for a patient with a Swan-Ganz catheter
- Does your patient have multi-system trauma requiring a trauma center?
- Allow the medical command physician to determine if a local EMS agency should transport the patient to decrease the time to the OR
- These are just a few examples in which patients may need critical care transport or C3IFT transport.
- The biggest determining factor is the stability and complexity of the patient
- KCEAA has 2 specialized CCT trucks that serve not only the county but many other areas of the state and provides a very limited resource.
All of KCEAA Paramedics have been trained at a higher level and have achieved the C3IFT requirements from the WVOEMS. On the next page you will find a list of medications they are allowed to transport.