Critical Care Transport

What Is Critical Care Transport?

Critical Care Transport (CCT) is a specialized interfacility transfer service, not a 911 scene response, that moves patients whose care exceeds what a standard ALS ambulance and crew are equipped or credentialed to manage: ventilated patients, multiple vasoactive drips (norepinephrine, epinephrine) running simultaneously, intra-aortic balloon pumps, or patients requiring blood product administration en route. Crews are typically a paramedic holding a critical care certification (CCP-C or FP-C) paired with a critical care RN, or in some systems an RN/RT team, since managing a ventilator and multiple infusion pumps together requires scope of practice beyond standard EMT-P protocols in most states. Common CCT moves include stepping a patient down from a rural ED to a tertiary trauma or cardiac center, transferring a STEMI patient post-cath, or moving a ventilated ICU patient between facilities for a higher level of specialized care.

Why Critical Care Transport Matters on the Fireground

A standard ALS crew running a patient on multiple vasoactive infusions without CCT-level training risks not recognizing a drip interaction or a subtle ventilator alarm until it becomes a crisis mid-transport, far from either facility's resources. Matching the transport level to the actual clinical complexity, not just to distance or availability, is what determines whether a deteriorating patient gets caught early or not.

Relevant NFPA Standards

• NFPA 455: Standard for Emergency Medical Services (EMS)
• NREMT Standards: National Registry of Emergency Medical Technicians Practice Standards

Field Procedures & Tactical Steps

1. Confirm the patient's clinical needs (ventilator, multiple drips, invasive monitoring) match the transporting crew's certification level before accepting the transfer.
2. Obtain a full report from the sending facility, including current drip rates, ventilator settings, and recent trends, before departure.
3. Continuously monitor and document vital signs, ventilator parameters, and infusion rates throughout transport, adjusting per medical direction as needed.
4. Deliver a structured handoff report to the receiving facility covering baseline status, any changes during transport, and interventions performed en route.

Common Context & Application

Requested for interfacility transfers when a patient's care, ventilator management, multiple vasoactive drips, balloon pumps, exceeds the scope of a standard ALS crew, most often moving patients from smaller facilities to a higher level of care.

Frequently Asked Questions about Critical Care Transport