Quote from SummitRN
Trauma Surfer... what is your opinion of air ambulances (which primarily deal in CCT) using Nurse/Medic staffing? That seems to be the most common staffing (a few are Nurse/Nurse or Nurse/RRT or even Nurse/MD).
After reading what other countries put their Nurses, RRTs and Paramedics through, I see some CCT transports as a band aid offering a speedy transport while hoping the patient doesn't die or require much intervention.
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You also must consider that the base education requirements for nurses, RRTs (Canada) and Paramedics in other countries are higher than the US. The US lags behind the rest of the civilized world in these professions which makes it disheartening to hear some RNs in the US complain about "all that time in school for an ADN" and see no use for the BSN.
Several of the teams which utilize RN/RN or RN/RRT also require them to obtain the EMT or Paramedic cert. Most can do this with an abbreviated course from a community college. But, it is still just an additional cert for a few specialty skills and knowledge to compliment the education (degree) and experience they already have in critical care. In some places an RN on a hospital based transport team will get more intubations in 1 month than many Paramedics get in 1 year or even 5 years according to the statistics. If that is the case, I would prefer two providers who have extensive critical care bedside experience over someone who has just a 2 week CCEMT-P certification.
But, some companies can not provide the intubation or current code experience for the RN so they rely on a Paramedic as the 2nd (and also for cost). This puts the majority of the "don't let them code" stress on the RN while the Paramedic might be very useful IF the patient codes. A Paramedic might be able to read a book or watch a video about an IABP or a ventilator to pass a test but until you have stayed for hours titrating meds and settings along with troubleshooting on multiple patients, you really are not equal for critical care experience and management of these patients. Short term management which is the focus of the Paramedic with a few meds and long term stabilization are two very different practices. The RN is accustomed to many more guidelines for titrating more meds specific to a disease process. The Paramedics goes with an algorithm which can be pretty generic for a short term transport. It is easier to teach an RN a few skills to compliment their education and experience from a critical care setting.
Of course not all RNs come from high acuity ICUs and not all Paramedics are equal. But, in the US, the expectations of the Paramedic is much lower for CCT teams. If you look at the ads, all they want from Paramedics are the basic requirements to maintain a Paramedic cert. Some might want the Flight or CCP certs but those are not that difficult and no additional degrees or experience is required. Some companies do want the RNs to hold BSNs along with a CCRN and other alphabet.
If the CCT also transports children and neonates, I think it should be an absolute requirement to have at least 1 year of experience in a Pediatric ICU and at least 1 year in a neonatal ICU. If the team is RN/Paramedic, it is just not safe for neither crew member to not have extensive bedside critical care experience for kids/babies and try to fly with just the "small adult" mentality.
Another thing I hear in the EMS community is that nobody supports them. But, few seem to have gotten involved to see who is going to bat for them for standards. This is an example from CAMTS. There are many organizations associated with EMS and Paramedics on various committees or directors which represent them.
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But, CAMTS is also a voluntary accreditation.
This is a good article. While what you said is true about RN/Paramedic being the most common crew configuration, the RRT is use as a 3rd 73%. Sometimes that might mean bumping the Paramedic.