# Umbc ccemtp



## ExpatMedic0 (Apr 22, 2013)

Has anyone taken this course at the UMBC? Is there any benefit at all to taking this on the UMBC campus, versus one of there satellite campuses (like a community college)

Any tips or feedback for this course?


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## MedicJenna (Apr 22, 2013)

I am very interested in this post. Look forward to hearing what others opinions are because I'm in the same boat as you!


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## Carlos Danger (Apr 22, 2013)

I took this course years ago when it was fairly new, and have since lectured in several of them, as well as similar, non-UMBC courses. When I was involved, the curriculum was very weak, but I've heard it has been updated and improved.

*What I can tell you for sure is that the quality of this course varies dramatically depending on where it is taught and who is teaching and coordinating it.* Some programs have all of the modules taught by real experts in those areas, and in some programs the content is taught by those with little or no actual experience in that area.  Some courses have heavy physician involvement, some have almost none at all (not that you necessarily have to have it, but I think, all things being equal, it's a good indicator). Some courses include excellent labs and clinical exposure, many do not include that at all. 

I have no personal knowledge of the Baltimore site, but I used to work with a handful of guys who took it there, and I've heard mixed things about it. One site I've heard consistently good things about is the one in Asheville, NC.

I've never taken Cleveland Clinic's CICP course, but their curriculum appears much more comprehensive than UMBC's, and I know at least one person who took both and said the CICP course was much better. 

My advice to anyone to who is considering this program is to do your homework, and also have realistic expectations. No matter how good the lecturers, there is only so much you can really learn and retain from a very brief program like this. Critical care is both very broad and very in depth, and even the best of these programs provide little more than an opportunity to dip your toe in the water.


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## Ecgg (Apr 22, 2013)

Halothane said:


> I took this course years ago when it was fairly new, and have since lectured in several of them, as well as similar, non-UMBC courses. When I was involved, the curriculum was very weak, but I've heard it has been updated and improved.
> 
> *What I can tell you for sure is that the quality of this course varies dramatically depending on where it is taught and who is teaching and coordinating it.* Some programs have all of the modules taught by real experts in those areas, and in some programs the content is taught by those with little or no actual experience in that area.  Some courses have heavy physician involvement, some have almost none at all (not that you necessarily have to have it, but I think, all things being equal, it's a good indicator). Some courses include excellent labs and clinical exposure, many do not include that at all.
> 
> ...



I have heard the same. From what others told me it's varies from place to place, and it's very plausible in fact it probably happens all the time, to have someone just read the slides with very little experience in said area. Although I doubt anyone will walk away from the entire course not getting anything out of it. If you are a medic there is only I believe 3 programs that offer Critical Care Transport education (if anyone knows of any other please list them)

1 CCEMTP/PNCCT various sites 
2 CICP various sites
3 Creighton 

Pick one that fits in your schedule, because ultimately the only credentials recognized by CAMTS is the BCCTP FP-C and CCP-C certifications. 
CAMTS 9th ED “FP-C or CCP-C certifications required for paramedics who conduct critical care transports and have been employed for more than 2 years”.

You can't learn critical care in 96-120 hours of class time, I view these classes as CME and nothing more than that.


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## EMS 911 (Apr 23, 2013)

ExpatMedic0 said:


> Has anyone taken this course at the UMBC? Is there any benefit at all to taking this on the UMBC campus, versus one of there satellite campuses (like a community college)
> 
> Any tips or feedback for this course?




I have never taken or had experience with the UMBC course, but I am in a CICP course (included in the undergrad degree I am in) and am testing this week for the exit exam. With the CICP course, ICU clinicals part of the practical portion, but not nearly as frequent as medic clinicals. I feel like I have learned, but I certainly don't feel comfortable with all of the aspects yet: mostly flight physiology, PA catheters, etc. It is definitely something that I would like more experience with before being on my own with a critical care transport. I could also use some more time to study on my own before testing for CCP-C or FP-C.

I have heard good and bad things about both the CCEMTP and CICP. Some like one better than the other and it often depends on how reputable the program is. The CICP course is not in Cleveland, but essentially same curriculum.


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## Handsome Robb (Apr 23, 2013)

We used to host one every 1-2 years. Haven't had one in a while unfortunately.

I'm pretty bummed they haven't had one and have no plans to run one.

From what I was told, and this is all hearsay so take it with a grain of salt, but supposedly it has to be taught primarily by physicians. Sounds like it was a recent change but I'm not sure if its true. 

I'm going to watch this thread closely, it's something I've been looking into for a while as well as ATLS and ACLS-EP.


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## Carlos Danger (Apr 23, 2013)

EMS 911 said:


> II certainly don't feel comfortable with all of the aspects yet: mostly flight physiology, PA catheters, etc. It is definitely something that I would like more experience with before being on my own with a critical care transport. I could also use some more time to study on my own before testing for CCP-C or FP-C.



That is a credit to you. To know what you are doing with an ICU patient takes a lot of experience. I think anyone who feels "comfortable" with ventilators or hemodynamic monitoring after a few hours of instruction is certifiably insane. There is good reason why hospitals are willing to spend tens of thousands of dollars to put new ICU nurses through orientation programs that are often 3-6 months or longer, full time. 

Unfortunately, I have seen plenty of folks who think their CCEMTP patch makes them a bona-fide transport intensivist, and it's dangerous for patients and disrespectful of those who have put in the time to gain the experience to really know what they are doing. 

Keep studying the stuff regularly, and if you haven't already, find a job with a CCT program that has a really strong educational program. The stuff will make sense once you get some real exposure to it.



Robb said:


> From what I was told, and this is all hearsay so take it with a grain of salt, but supposedly it has to be taught primarily by physicians. Sounds like it was a recent change but I'm not sure if its true.



If that is true, it is a recent change and also very unfortunate, IMO. It would likely raise the cost of the course significantly and would definitely make them harder to coordinate, with no guarantee of any improvement in quality. Some of the best teachers of this stuff are RN's, RRT's, and flight paramedics.


For whatever my opinion is worth, I really don't recommend CCEMTP or similar courses for anyone who isn't immediately going into critical care transport. The reason is simple: They don't provide nearly enough education for you to really _learn_ the material, and if you don't reinforce what you learned with ongoing CCT education and by using it everyday, you just won't retain it. Personally, I would spend my time and money on other education.

One course that I do recommend is Fundamental Critical Care Support by the SCCM. It is not transport-specific, but it covers all the major critical care topics with a focus on the first 24 hours of management. It is two days long and I really think for most people, you'll get just as much out of this as you would a two-week CCEMTP course.


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## ExpatMedic0 (Apr 26, 2013)

Halothane said:


> Unfortunately, I have seen plenty of folks who think their CCEMTP patch makes them a bona-fide transport intensivist, and it's dangerous for patients and disrespectful of those who have put in the time to gain the experience to really know what they are doing.
> 
> If that is true, it is a recent change and also very unfortunate, IMO. It would likely raise the cost of the course significantly and would definitely make them harder to coordinate, with no guarantee of any improvement in quality. Some of the best teachers of this stuff are RN's, RRT's, and flight paramedics.
> 
> ...


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## medicdan (Apr 26, 2013)

Halothane said:


> One course that I do recommend is Fundamental Critical Care Support by the SCCM. It is not transport-specific, but it covers all the major critical care topics with a focus on the first 24 hours of management. It is two days long and I really think for most people, you'll get just as much out of this as you would a two-week CCEMTP course.



I'm taking an FCCS course in a few weeks, and have heard different reactions to the curriculum. I don't expect (or want it) to be all-inclusive, but an introduction to critical care patient management. I'd like to use the knowledge as a starting point to find more education, and develop my skills and assessments. 
Do you have any advice re: how to approach materials, or other ways of developing education after FCCS?


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## Carlos Danger (Apr 26, 2013)

emt.dan said:


> I'm taking an FCCS course in a few weeks, and have heard different reactions to the curriculum. I don't expect (or want it) to be all-inclusive, but an introduction to critical care patient management. I'd like to use the knowledge as a starting point to find more education, and develop my skills and assessments.
> Do you have any advice re: how to approach materials, or other ways of developing education after FCCS?



I think the curriculum itself is excellent. Some in EMS might not like it because it's not transport specific. But it is all about _early_ critical care, so I think it's highly pertinent as an introduction for any paramedic who wants to get involved in CCT. It's all about the type of stuff you might see in a trauma patient or a vented septic shock patient who you've been called to transport from an ED to a tertiary ICU. And I think what I like about it the most is that it's practical, useful information. Not overly in depth.

Like CCEMTP, the quality of the program can vary as the instructors are different from site to site, but I think it is a lot less of a problem than CCEMTP because with FCCS, all the instructors are members of the SCCM and work in critical care.  

Do you have the FCCS textbook yet? It's an excellent introductory text, IMO. 

In order to prepare, I would look through the book and make notes of any areas that you really feel clueless about. Then do a little reading on those areas and write down questions to ask during the course. The point isn't at all to learn the material before the course, but you'll probably get more out of it if you've prepared some ahead of time.

Do you plan to get involved in CCT? Or are you already?


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## Clipper1 (Apr 26, 2013)

emt.dan said:


> an introduction to critical care patient management. I'd like to use the knowledge as a starting point to find more education, and develop my skills and assessments.



Just remember there is a big difference in "introduction to critical care" and "critical care patient management".  

Every area of critical care is a specialty and even for those who work in ICUs every day take many hours of classroom and on the job experience to effectively manage just some of the specialties.  Cardiac and Neuro are two big areas and both cover a lot of material.  Often these intro courses just give a brief overview and teach nothing about the actual management of the patient.  This is why hospitals usually set up the pumps and hopefully help with the ventilator settings to where many CCTs are just babysitting jobs and you hope nothing happens enroute.  When in doubt, most CCT companies will have a disclaimer that "the hospital should send a qualified provider such as an RT, RN, NP, PA or MD with the patient".   You can find that on many of the contracts  made between CCT providers and the hospitals and LTACs. 

The better CCTs or Flight teams will usually pair the Paramedic with an experienced critical care RN as well as offering many additional hours of training.   CCT and Flight RNs usually will still work in a hospital part time to stay current on their critical care knowledge.  There is nothing worse than giving or getting a transfer report from an RN who has not stayed current or a Paramedic who has only the CCEMT-P patch for knowledge or critical care experience.  You spend the next few hours worrying about the patient and if you could be held responsible for allowing the patient to leave your ICU or you are looking for mistakes and changing every med drip and tubing per your hospital's policy.


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## Ecgg (Apr 26, 2013)

Halothane said:


> I think the curriculum itself is excellent. Some in EMS might not like it because it's not transport specific. But it is all about _early_ critical care, so I think it's highly pertinent as an introduction for any paramedic who wants to get involved in CCT. It's all about the type of stuff you might see in a trauma patient or a vented septic shock patient who you've been called to transport from an ED to a tertiary ICU. And I think what I like about it the most is that it's practical, useful information. Not overly in depth.
> 
> Like CCEMTP, the quality of the program can vary as the instructors are different from site to site, but I think it is a lot less of a problem than CCEMTP because with FCCS, all the instructors are members of the SCCM and work in critical care.
> 
> ...




Any experience with http://www.learnicu.org/Fundamentals/Pages/FCCS.aspx
FCCS online course? Compared to in person, in terms of hands on practice with equipment.


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## Ecgg (Apr 26, 2013)

Clipper1 said:


> Just remember there is a big difference in "introduction to critical care" and "critical care patient management".
> 
> Every area of critical care is a specialty and even for those who work in ICUs every day take many hours of classroom and on the job experience to effectively manage just some of the specialties.  Cardiac and Neuro are two big areas and both cover a lot of material.  Often these intro courses just give a brief overview and teach nothing about the actual management of the patient.  This is why hospitals usually set up the pumps and hopefully help with the ventilator settings to where many CCTs are just babysitting jobs and you hope nothing happens enroute.  When in doubt, most CCT companies will have a disclaimer that "the hospital should send a qualified provider such as an RT, RN, NP, PA or MD with the patient".   You can find that on many of the contracts  made between CCT providers and the hospitals and LTACs.
> 
> The better CCTs or Flight teams will usually pair the Paramedic with an experienced critical care RN as well as offering many additional hours of training.   CCT and Flight RNs usually will still work in a hospital part time to stay current on their critical care knowledge.  There is nothing worse than giving or getting a transfer report from an RN who has not stayed current or a Paramedic who has only the CCEMT-P patch for knowledge or critical care experience.  You spend the next few hours worrying about the patient and if you could be held responsible for allowing the patient to leave your ICU or you are looking for mistakes and changing every med drip and tubing per your hospital's policy.



This is a very grim outlook on things especially for new medics who are trying to find resources to advance their already limited education in critical care environment. Not every medic wants to become an RN so that is not a solution and not all programs that conduct CCT allow additional hours of training for their medics in the hospital.

In an ideal world everyone is trained and has experience. In the real world you will find fresh out of school medics conducting CCT with no critical care training. Blaming the service does nothing productive. What is your solution for these guys? Where should they go if they want further education?


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## Flight-LP (Apr 26, 2013)

I see two problems here. One is a geographical problem that is overgeneralized. Perhaps some non-pro EMS areas such as Cali restrict the function of a medic in the critical and specialty care environment. Other areas have no such restrictions and have successfully operated paramedic led teams in multiple disciplines. For example, I have never had, nor would allow anyone other than myself or my crew member to set up our ventilator or pump. For one it is not needed and two it places accountability on the CCT crew. I have routinely taken CVICU patients post IABP placement with multiple drips and on the ventilator. No RN, no perfusionist, just me, my CCT Paramedic partner and a driver. I have never had an issue. Why?

Because there can be success in thinking outside the box, it just requires collaboration of the whole team, understanding and respect of the various roles, and some good old fashion education and training. 

The second problem is the allowance of an entity to operate in such capacity without verification and validation. I see quite a few companies offering the CCT services with a 2 person crew in a van with a medic that may have taken some kind of training course years ago. There has to be organization and a well developed concept in the program. The units must be appropriately equipped, not just carrying an old hospital pump and a POS Autovent. 

The problem lies at both ends, but can be well run and safe for the increasing population of high acuity patients.


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## Summit (Apr 26, 2013)

I hope what Clipper is doing is pointing out reality and standards of care so that providers will have realistic appraisals of their capability and training. 



Flight-LP said:


> it just requires collaboration of the whole team, understanding and respect of the various roles, and some good old fashion education



What does this mean in your service?


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## Clipper1 (Apr 26, 2013)

Summit said:


> I hope what Clipper is doing is pointing out reality and standards of care so that providers will have realistic appraisals of their capability and training.



That is exactly the point I was attempting to make.


An example:



Flight-LP said:


> For example, I have never had, nor would allow anyone other than myself or my crew member to set up our ventilator or pump. For one it is not needed and two it places accountability on the CCT crew. I have routinely taken CVICU patients post IABP placement with multiple drips and on the ventilator. No RN, no perfusionist, just me, my CCT Paramedic partner and a driver. I have never had an issue. Why?
> 
> Because there can be success in thinking outside the box, it just requires collaboration of the whole team, understanding and respect of the various roles, and some good old fashion education and training.



When you down play the seriousness of some critical patients to think that a Paramedic is equal to an RN or Perfusionist you will not be doing the patient any favors.  To say you have NEVER had an issue may just mean you do very few transports or just very lucky. Even the most seasoned critical care professionals encounter issues.  

It is also not a sign of weakness if you allow someone to give you assistance in setting up a drip or a ventilator especially if they have been taking care of this patient for several hours or several days and can offer great advice. They may already have done transports within the hospital for various diagnostic procedures and will know how the patient tolerates a transport ventilator or movement.  Never be so cocky to say "Never" when it comes to providing what is best for the patient.  You should also not view every critical care transport as just routine. 

There are also more intense patients which do require the expertise of others such as RNs and/or Perfusionists on transports. How many ECMO patients do you transport "routinely"?   How many 23 week babies with CHD do you transport daily or even monthly? 





> Originally Posted by Flight-LP View Post
> it just requires collaboration of the whole team, understanding and respect of the various roles, and some good old fashion education



You left out experience.  The success of some transports depends on those who do things repetitively every day on the job. Even then as routine as it might seem it may be anything but routine. Those who have been in the critical care settings with lots of experience do realize this. 

There also is not much time for teaching everything you should know for a transport. Some have shown up in the ICUs and expect to be educated on every med drip, equipment and disease from scratch. While most everyone in the ICU is willing to teach and show but sometimes teaching the fundamentals along with the advanced is time consuming and does not inspire much confidence for the abilities of the team one is about to turn over care to.


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## Clipper1 (Apr 26, 2013)

Ecgg said:


> This is a very grim outlook on things especially for new medics who are trying to find resources to advance their already limited education in critical care environment. Not every medic wants to become an RN so that is not a solution and not all programs that conduct CCT allow additional hours of training for their medics in the hospital.



Sometimes it is hard to have it both ways. Most here would tell an RN to go to Paramedic school if they want to be a Paramedic.  The education of the Paramedic in the United States was for prehospital care for emergent situations to provide care just long enough to get to a facility. Unfortunately some in EMS have adopted this same concept of training to just move a patient from point A to point B when establishing CCTs.  

If you want to do Critical Care well, you really should have many 1000s of hours at the bedside doing hands on care of many critical patients titrating multiple drips, working with various equipment and interpreting lab values as they PERTAIN  to the patient and meds you are giving. Anyone can look at textbook values and say high or low.


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## Carlos Danger (Apr 26, 2013)

Ecgg said:


> *This is a very grim outlook on things especially for new medics who are trying to find resources to advance their already limited education in critical care environment. *Not every medic wants to become an RN so that is not a solution and not all programs that conduct CCT allow additional hours of training for their medics in the hospital.
> 
> In an ideal world everyone is trained and has experience. In the real world you will find fresh out of school medics conducting CCT with no critical care training. Blaming the service does nothing productive. What is your solution for these guys? Where should they go if they want further education?



Yeah, unfortunately, quality critical care education is pretty limited for paramedics, mostly because it takes a lot of time and clinical experience to really learn what you are doing with an ICU patient.

The best option, I think, is to get with a service that does CCT and has a really strong initial and continuing education program.

There is a lot of good stuff on the internet, both formal and informal, like podcasts, blogs, youtube videos, etc. It doesn't take the place of clinical experience, of course, but the info itself is not hard to come by. 

Use something like FCCS or CCEMTP as a foundation, and then search out more info online or in textbooks.

But really, I can't stress enough how much more you'll learn by actually doing the job. 

I did flight, CCT, and ICU for years and did a fair amount of teaching and writing along the way. I'm not real up on all the current programs that are out there, because for the past few years I've been focusing on grad school rather than CCT education. But I am all about helping paramedics who want to learn. If you have any specific questions please feel free to PM me.


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## ExpatMedic0 (Apr 26, 2013)

Hey guys, I know critical care is a hot topic, but per the thread topic, I am looking to hear from people who have taken the CCEMTP and have information related to it. I am considering signing up for the class on the UMBC campus this July. Thanks


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## Flight-LP (Apr 26, 2013)

Clipper1 said:


> That is exactly the point I was attempting to make.
> 
> 
> An example:
> ...



I don't remember verbalizing any level of downplay or equality.




Clipper1 said:


> It is also not a sign of weakness if you allow someone to give you assistance in setting up a drip or a ventilator especially if they have been taking care of this patient for several hours or several days and can offer great advice. They may already have done transports within the hospital for various diagnostic procedures and will know how the patient tolerates a transport ventilator or movement.  Never be so cocky to say "Never" when it comes to providing what is best for the patient.  You should also not view every critical care transport as just routine.



Again, no where in my post was weakness or a lack of collaboration mentioned. In fact, the opposite is my position. During transport though, the patient is in our care, therefore we need to ensure the proper operation of our equipment and the care of the patient while utilizing that equipment. Not all ICU staff are familiar with the transport equipment such as the ProPak MD, the LTV 1200, or the various pumps. It has nothing to do with being cocky. it is about maintaining accountability.



Clipper1 said:


> There are also more intense patients which do require the expertise of others such as RNs and/or Perfusionists on transports. How many ECMO patients do you transport "routinely"?   How many 23 week babies with CHD do you transport daily or even monthly?



Not many ECMO transports these days as our facility doesn't do ECMO, we transfer those to another nearby tertiary facility. Being a dedicated Neo transport team, we do an average of 25-30 neo transports / month. I'd have to get back to you on the total number of 23 week's though. Please tell me specifically what expertise is needed from the RN or Perfusionist? Honestly it comes down to credentialing and standing guidelines, regardless of the professional. If the medical director provides the appropriate credentialing through hands on training, appropriate education, and direct patient care exposure, why do we have to fall back to the antiquated "I'm a RN" or "you're just a Paramedic"? Instead of arm chair quarterbacking, why not let the actual MD responsible for the delivery of care make the decisions? Who are you to judge?



Clipper1 said:


> You left out experience.  The success of some transports depends on those who do things repetitively every day on the job. Even then as routine as it might seem it may be anything but routine. Those who have been in the critical care settings with lots of experience do realize this.



You are correct, I absolutely agree with you on this one.  



Clipper1 said:


> There also is not much time for teaching everything you should know for a transport. Some have shown up in the ICUs and expect to be educated on every med drip, equipment and disease from scratch. While most everyone in the ICU is willing to teach and show but sometimes teaching the fundamentals along with the advanced is time consuming and does not inspire much confidence for the abilities of the team one is about to turn over care to.



Some have shown up with an expectation of education, other arrive prepared to deal with the dynamics of the high acuity patient. Believe it or not, there are Paramedics out there fully capable of doing it.


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## Clipper1 (Apr 26, 2013)

Flight-LP said:


> Not many ECMO transports these days as our facility doesn't do ECMO, we transfer those to another nearby tertiary facility. Being a dedicated Neo transport team, we do an average of 25-30 neo transports / month. I'd have to get back to you on the total number of 23 week's though. Please tell me specifically what expertise is needed from the RN or Perfusionist? Honestly it comes down to credentialing and standing guidelines, regardless of the professional. If the medical director provides the appropriate credentialing through hands on training, appropriate education, and direct patient care exposure, why do we have to fall back to the antiquated "I'm a RN" or "you're just a Paramedic"? Instead of arm chair quarterbacking, why not let the actual MD responsible for the delivery of care make the decisions? Who are you to judge?



I wasn't armchair quarterbacking. There  are certain aspects of critical care which deserves more than just a take my word for things. You don't seem to like to be questioned about specifics so you probably won't like my next few questions.

Is the LTV 1200 your neonatal transport ventilator since you are part of a dedicated neonatal transport team? 

Why do you assume ECMO is only for neonates? Adult ECMO is also mobile and is done on CCTs.  When you did do ECMO transports since that is what I get from your post, was it only you and the other Paramedic with a driver?

Why do you assume the ICU staff who may have been caring for the patient for several hours or even days will know nothing about the patient and you seem to not want to take any advice from them?  The "its my patient now" stuff may work in the field but you will find that the ICU staff might just provide some useful information. Also, the ICU physician can intervene and call for a different truck or put his staff on the truck if he or she feels you are not competent which also includes acting like a jerk in their ICU.


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## Flight-LP (Apr 27, 2013)

Clipper1 said:


> I wasn't armchair quarterbacking. There  are certain aspects of critical care which deserves more than just a take my word for things. You don't seem to like to be questioned about specifics so you probably won't like my next few questions.
> 
> Is the LTV 1200 your neonatal transport ventilator since you are part of a dedicated neonatal transport team?



Nope. We use the Crossvent 2+ and 2i on our ground and flight isolettes. 



Clipper1 said:


> Why do you assume ECMO is only for neonates? Adult ECMO is also mobile and is done on CCTs.  When you did do ECMO transports since that is what I get from your post, was it only you and the other Paramedic with a driver?



No assumptions here, only speculated perceptions from you my friend. I am well aware of the ECMO process and it's advantages to the various populations. The previous program that I performed ECMO with used a variety of crew configuration dependent on the patient age and team responding. It was usually a Paramedic, an RN or NNP, an RT (if needed), and a perfusionist. 



Clipper1 said:


> Why do you assume the ICU staff who may have been caring for the patient for several hours or even days will know nothing about the patient and you seem to not want to take any advice from them?  The "its my patient now" stuff may work in the field but you will find that the ICU staff might just provide some useful information. Also, the ICU physician can intervene and call for a different truck or put his staff on the truck if he or she feels you are not competent which also includes acting like a jerk in their ICU.



Again, no assumptions here. The reality at the end of the day is when you service over 40 tertiary medical facilities with ICU's, there usually is not a continuity of understanding of the transport crew's equipment, especially when it comes to agency and per diem RN's that may only have limited familiarity with that location. While the transport crews do try to educate, you are talking a huge educational learning curve. 40+ hospitals, hundreds of EMS agencies, 5 different air medical agencies, 3 medical schools, and an ungodly number of staffing agencies quickly equates to a potential problem without communication and accountability. 

I really believe you are splitting hairs on this topic as I am only making the assertion that I check and double check all of my diagnostic and intervention equipment. There is a reason why I have the exposure and experienced gained over the last decade in critical care medicine. Part of it is opportunity, but a lot is collaboration and trust. Here in Houston, there is a level of trust, faith, organization, experience, education, and professionalism among several high class agencies. I realize that is not the case nationwide and not something that is experienced by all ICU staff in many locations. Perhaps it is a unique environment, maybe it's a fluke. I have my opinion, you have yours. It's nothing more than that, why make it into more? Let's agree to disagree and get back on topic to help the OP out with his original inquiry.


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## Clipper1 (Apr 27, 2013)

Flight-LP said:


> Again, no assumptions here. The reality at the end of the day is when you service over 40 tertiary medical facilities with ICU's, there usually is not a continuity of understanding of the transport crew's equipment, especially when it comes to agency and per diem RN's that may only have limited familiarity with that location. While the transport crews do try to educate, you are talking a huge educational learning curve. 40+ hospitals, hundreds of EMS agencies, 5 different air medical agencies, 3 medical schools, and an ungodly number of staffing agencies quickly equates to a potential problem without communication and accountability.



I think you are missing the point.  Just because the RN caring for the ICU patient is from an agency or PRN does not mean they do not know the patient.  You need to also listen to what they know and don't assume your transport equipment or transport is unfamiliar to all.  Nor should you assume you know it all and that the RNs don't.  Don't try to preach professionalism with that attitude.   You can earn a lot more trust if you actually listen to the report and also the suggestions made by the staff caring for the patient. You might actually learn a few things which the patient could benefit from.  Just because a hospital has requested a patient to be transferred does not mean the staff is stupid or incompetent. There are many reasons for a transfer which includes ECMO or other specialized services.  If you are on a dedicated neonatal team you should know this. Level 3 nurseries have very competent staff but may not offer ECMO. That does not make them any less of a professional.   

Believe it or not but we also have many different hospitals including large teaching ones and med schools here in the NW part of the US.  Our neonatal teams are well respected and they don't feel the need to insult the staff at the sending hospitals.


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## ExpatMedic0 (Apr 28, 2013)

Anyone else signing up for July CCEMTP at UMBC? or have feedback regarding it (that have actually taken the course)


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## ExpatMedic0 (Apr 30, 2013)

Also, I am looking into couchsurfing.org Hopefully I do not end up in someones meat locker. If anyone wants to pitch in on a very cheap place together or, even better, knows of a reliable couch to surf for 2 weeks near the UMBC, let me know.


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## ExpatMedic0 (May 2, 2013)

Got the AAOS UMBC critical care book the mail today... 1034 pages. A lot bigger than I imagined for a 2 week course. That, plus the flight nurse ASTNA book I got, which is 1271 pages.... Guess I will be reading a lot! :wacko:


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