CCT Scope of Practice

  Category Skill Critical Care Transport Provider (Paramedic, PHRN, PHPE or PHP)
1 Airway/ventilation/oxygenation Chest tube thoracostomy, monitoring of existing tube in a closed system (for example water seal or suction) Yes1
2 Airway/ventilation/oxygenation Chest thoracostomy (tube or finger), acute insertion Yes2
3 Airway/ventilation/oxygenation Biphasic positive airway pressure (BiPAP) for patients acutely on BiPAP for <48 hours Yes1
4 Airway/ventilation/oxygenation Endotracheal Intubation—paralytic assisted, rapid sequence induction (RSI) Yes2
5 Airway/ventilation/oxygenation Escharotomy Yes2
6 Airway/ventilation/oxygenation Ventilation—Maintenance of previously initiated neuromuscular blockade Yes1
7 Airway/ventilation/oxygenation Laryngeal mask airway (LMA) Yes1
8 Airway/ventilation/oxygenation Ventilators, that are portable and capable of being transported with a patient and are multi-modal, with a blender, that are used on patients requiring pressure control, pressure support or other advanced setting, or when there is an anticipated need by a healthcare provider involved with the care of the patient to actively titrate ventilator settings during transport, regardless of ventilation mode Yes1
9 Airway/ventilation/oxygenation Ventilators, transport—used in multi-modal settings, blended gas transport ventilator on patients ventilated <48 hours or anticipated need to actively titrate ventilator settings Yes2
10 Cardiovascular/circulation Transvenous or Epicardial pacing, Management of Yes2
11 Cardiovascular/circulation Hemodynamic monitoring/assist (pulmonary artery catheter, central venous pressure) Yes2
12 Cardiovascular/circulation Intra-aortic balloon pump or invasive cardiac assist device or extracorporeal membrane oxygenation—monitoring/assist Yes2
13 Cardiovascular/circulation Thrombolytic therapy—initiation Yes2
14 Cardiovascular/circulation Thrombolytic therapy—monitoring Yes2
15 Cardiovascular/circulation Pericardiocentesis Yes2
16 IV Initiation/maintenance/fluids Sub-cutaneous indwelling catheters—access of existing catheters Yes1
17 IV Initiation/maintenance/fluids Venous central line (blood sampling)—obtaining Yes1
18 IV Initiation/maintenance/fluids Arterial line—monitoring Yes1
19 IV Initiation/maintenance/fluids Blood products—continued administration of blood products initiated at sending facility Yes1
20 IV Initiation/maintenance/fluids Blood products—initiation of infusion Yes2
21 Medication administration routes Enteral Feeding Devices, Management of Yes1
22 Medications Medications for Critical Care Transport Providers as published in Pennsylvania Bulletin by the Department Yes1
23 Medications Over-the-counter (OTC) medications (Note: aspirin and glucose covered elsewhere) Yes1
24 Patient Assessment/management Portable blood analysis devices, use of (glucometer covered elsewhere) Yes1
25 Patient Assessment/management Intracranial pressure monitoring/assist Yes2
26 Patient Assessment/management Urinary catheterization Yes1

Yes—The skill is in the scope of practice for Ps, PHRNs, PHPEs and PHPs who are authorized to function for an EMS agency that has been licensed as a CCT ambulance service.

  1. Ps, PHRNs, PHPEs and PHPs who are authorized to function for an EMS agency that has been licensed as a CCT ambulance service may only perform or assist with these skills during interfacility transport with a CCT ambulance.
  2. Ps who are authorized to function for an EMS agency that has been licensed as a CCT ambulance service may assist a PHRN, PHPE or PHP with this skill only during interfacility transport with a CCT ambulance and when in the direct physical presence of, and supervised by, the higher level provider.