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.
- 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.
- 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.