Medicine:FP-C

Certified Flight Paramedic

The Flight Paramedic Certification (FP-C) is an advanced certification that indicates an individual has attained the designation of Certified Flight Paramedic. The FP-C certification exam is administered by the International Board of Specialty Certification (IBSC) and the Board for Critical Care Transport Paramedic Certification (BCCTPC), a not-for-profit organizations responsible for the administration and development of specialty certification exams for critical care professionals. The test is administered by PSI and Applied Measurement Professionals (AMP) to assure compliance with the highest testing standards. This certification is designed to be successfully approved only for experienced paramedics who have demonstrated advanced knowledge of critical care medicine by passing an exam consisting of 125 scored items and 10 unscored items within a 2.5 hour window. As of February 22, 2018 there are 6458 certified flight paramedics worldwide, 494 of whom hold dual certification as a CCP-C.

The FP-C, or CCP-C, and/or Critical Care Emergency Medical Transport Program (CCEMTP) certifications are often a requirement to work as a flight paramedic in the United States. The FP-C does not have an associated course, unlike the CCEMTP, although review courses and study guides available. The FP-C is considered comparable in difficultly to the Critical Care Paramedic Certification (CCP-C). Experience in the air medical or critical care transport fields is recommended before attempting to take the exam. However, there is no minimum education component required, and the examination does not require minimum years of experience, therefore new paramedics who have just completed school are eligible to take the exam and receive certification. In addition, there is no practical skills test associated with the examination, unlike the NREMT paramedic exam. Many agencies may require prospective employees to demonstrate practical competency in other courses (TPATC, ATLS-audit, CCEMTP, etc.) prior to being considered for employment. A candidate must hold a current paramedic license and have active certifications in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Prehospital Trauma Life Support (PHTLS), and other advanced certifications.

Examination

The exam is administered by the Board for Critical Care Transport Paramedic Certification (BCCTPC). Oversight for the exam process is provided by Applied Measurement Professionals (AMP), a statistical body that ensures the certification process is in compliance. The methods used by AMP are consistent with professional and technical guidelines detailed in the Standards for Educational and Psychological Testing (1999) by the American Educational Research Association, the American Psychological Association and the National Council on Measurement in Education. These standards provide the research framework that is used as a basis for validity of certification. The methodology used meets or exceeds the current professional and governmental standards to assure the defensibility of the exam, as well as meets or exceeds the standards of the National Commission for Certifying Agencies (NCCA) and the National Organization for Competency Assurance (NOCA). Although the FP-C is not officially recognized by the National Registry of Emergency Medical Technicians (NREMT), it has become the standard for critical care paramedic certification and is considered to be the highest level of paramedic certification in the USA. Unlike the NREMT Paramedic examination, which is required in most states for entry-level paramedic licensure, the FP-C is a professional certification that evaluates knowledge well above and beyond the basic scope of practice of most licensed paramedics.

FP-C Study Recommendations

• Air and Surface Patient Transport: Principles & Practice (5th ed.) Holleran, R. (Ed.). Philadelphia: Elsevier Health Sciences, 2017. ISBN:9780323401104
• 10th edition CAMTS accreditation standards.
• FlightBridgeED, LLC - "Live" in person FP-C, CCP-C & CFRN or Online University FP-C, CCP-C & CFRN Critical Care Review Courses

Additional FP-C Study Resources

• Critical Care Transport (2nd Edition) by the American Academy of Orthopaedic Surgeons (AAOS), the American College of Emergency Physicians (ACEP) and UMBC. Published by Jones & Bartlett Learning (2017). ISBN:978-1284040999
• The FlightBridgeED Podcast - Critical Care Medicine Education
• FlightBridgeED FP-C | CFRN Certification Review & Advanced Practice Update ISBN:978-1492168553
• FlightBridgeED - FAST Exam Prep Book
• Flight Paramedic Certification: A Comprehensive Study Guide by Kyle Faudree available at the IAMED Store
• The Walls Manual of Emergency Airway Management, (5th Edition) by Calvin A Brown III MD (Editor), John C Sakles (Editor), Nathan W. Mick MD (Editor), Published by LWW (Wolters Kluwer 2018). ISBN:978-1496351968
• Remote and Austere Medicine Field Guide for Practitioners available at the College of Remote and Offshore Medicine

Exam Outline of Major Subjects (FP-C and CCP-C)

Safety Issues

• Ambulance safety issues
• Ambulance Operations, scene and highway safety
• Crash safety
• Proper safety equipment

CAMTS: You should be familiar with all CAMTS policies such as

• Ambulance specifications
• Safety education
• Driver qualifications
• Staffing and schedules
• Equipment and operations around the ambulance.

Airway

• Rapid Sequence Induction inclusive of standard medications.
• Intubation and other airway procedures.
• Surgical cricothyroidotomy, Needle cricothyroidotomy
• Airway medications and their uses, limitations, and contraindications.

Lab Analysis

• Regulation of acid-base balance
• Acid-base derangements
• Causes and correction of abnormal lab values

OB/GYN

• Fetal circulation
• Recognition and treatment of maternal complications.
• Delivery Complications
• Postpartum complications
• Maternal Medications
• Fetal monitoring

Trauma

• Administration of blood products
• Fluid replacement
• Trauma scoring systems
• Recognize and manage critical trauma injuries
• Predictable patterns of injury due to mechanisms.
• Burn assessment and management

Respiratory

• Identify and interpret blood gases
• Ventilator settings and parameters
• Equipment, uses and troubleshooting
• Capnography waveforms
• Managing the rapidly deteriorating patient condition.

Thoracic

• Signs and symptoms of early versus late cardiac tamponade.
• Procedures pertaining to thoracic injuries.
• Needle thoracentesis, pericardiocentesis, thoracostomy tube placement, etc.
• Treatment and signs and symptoms of cardiac tamponade, tension pneumothorax, hemothorax, etc.

Neuro

• Treatment and recognition of elevated intracranial pressure.
• Neuroprotective agents, vasoactive agents, loop diuretics, etc. and their uses, limitations, and contraindications.
• Types of strokes, their assessment and management
• Differentiation of signs and symptoms of head injuries,
• Intracranial Pressure monitoring, cerebral perfusion pressures.
• Mechanism of Injury and head injury dynamics.
• Spinal cord injuries and management

Cardiac

• Knowledge of cardiovascular disease, cardiac anomalies and their treatment.
• 12 lead EKG's
• EKG changes associated with drug, electrolyte, or medical conditions.
• Cardiac Anatomy/Physiology
• Cardiac Pharmacology
• Thrombolytic therapy
• A basic understanding of intra-aortic balloon pump (IABP) mechanics and troubleshooting/contraindications.
• Hemodynamic monitoring
• Arterial line management
• Pacing, synchronized cardioversion, defibrillation, and medications

Pediatric and Neonatal

• Pediatric and Neonatal resuscitation
• Physiological and anatomical differences
• Pharmacology
• Congenital abnormalities
• Pediatric assessment
• Recognition and treatment of conditions and complications
• Transitional circulation
• Respiratory and Airway differences
• Common medical and trauma emergencies
• Vascular access
• Pediatric psychosocial issues
• Non-accidental trauma
• Isolette use in transport

Exam Outline

Certified Flight Paramedic Candidate Handbook (Content Outline)

Question Category	Number of Questions
Safety/Transport Fundamentals and Post Incident Survival	10
Flight Physiology	9
Advanced Airway Management Techniques	15
Trauma and Burn Emergencies	19
Neurological Emergencies	9
Cardiopulmonary Emergencies	25
Toxic and Environmental Exposures	9
Perinatal and Pediatric Emergencies	19
General Medical Patient	10

FP-C Detailed Content Overview

• Safety/Transport Fundamentals and Post Incident Survival (10)
  • Assess the safety of the scene
  • Conduct preflight checks to ensure aircraft integrity
  • Conduct preflight checks to ensure equipment is present, functional, and stowed
  • Observe for hazards during aircraft operation
  • Utilize proper safety equipment while in flight
  • Maintain a sterile cockpit during critical phases of flight
  • Approach and depart the aircraft in a safe manner
  • Ensure safety around the aircraft
  • Secure the patient for flight
  • Understand Human Factors Resource performance as it pertains to clinical and aviation performance
  • Participate in flight mission safety decisions (e.g., Go/No Go, abort)
  • Respond to in-flight emergencies: 1. fire 2. emergency egress 3. emergent landing 4. adverse weather conditions 5. de-pressurization
  • Perform immediate post-accident duties at a crash site
  • Build survival shelters
  • Initiate emergency survival procedures
  • Ensure the safety of all passengers (including specialty teams, family, law enforcement, observer)
  • Understand the weather conditions that impact flight operations
  • Understand safety management systems
  • Understand Just culture
• Flight Physiology (9)
  • Identify causes of hypoxia
  • Relate the stages of hypoxia to patient condition and treatment
  • Take corrective measures to prevent altitude related hypoxia
  • Identify signs of barometric trauma
  • Identify stressors related to transport (including thermal, humidity, noise, vibration, or fatigue related conditions)
  • Take corrective action for patient stressors related to transport
  • Relate the relevant gas laws to patient condition and treatment
  • Identify immediate causes of altitude related conditions in patients
  • Identify immediate causes of altitude related conditions as they affect the air medical crew
  • Provide appropriate interventions to prevent the adverse effects of altitude changes during patient transport
• Advanced Airway and Ventilation Management (15)
  • Identify the indications for basic and advanced airway management
  • Perform advanced airway management techniques
  • Administer appropriate medications for airway management
  • Identify the indications and contraindications for specific airway interventions
  • Implement the appropriate airway algorithm
  • Manage complications of intubation
  • Perform alternative airway management techniques
  • Monitor airway management and ventilation (including capnography) during transport
  • Implement ventilation settings to react to the patient's condition
• Trauma and Burn Emergencies (19)
  • Perform patient triage (including MCI and WMD incidents)
  • Differentiate injury patterns associated with specific mechanisms of injury
  • Rate a trauma victim using the Revised Trauma Score
  • Rate a trauma victim using the Trauma Injury Severity Score (TRISS)
  • Identify patients who meet trauma center criteria
  • Perform a comprehensive assessment of the trauma patient
  • Initiate the critical interventions for the management of the trauma patient
  • Provide care for the patient with thoracic injuries
  • Provide care for the patient with abdominal injuries
  • Provide care for the patient with orthopedic injuries
  • Administer appropriate medications for trauma management
  • Assess a patient using the Glasgow Coma Scale/Score (GCS)
  • Manage patients with head injuries
  • Manage patients with spinal cord injuries
  • Perform a baseline neurologic assessment of a trauma patient
  • Perform an assessment of the burn patient
  • Calculate the estimated percentage of the body surface area burned
  • Calculate appropriate fluid replacement amounts based on the patient’s burn injury and physiologic condition
  • Diagnose inhalation injuries in burn injury patients
  • Perform escharotomies on burn injury patients
  • Administer medications for burn patients
  • Provide treatment of burn emergencies
• Neurological Emergencies (9)
  • Conduct differential diagnosis of coma patients
  • Manage patients with seizures
  • Manage patients with cerebral ischemia
  • Initiate the critical interventions for the management of a patient with a neurologic emergency
  • Provide care for a patient with a specific neurologic emergency
  • Perform an ongoing serial evaluation of a neurologic patient
  • Assess changes in intracranial pressure using patient level of consciousness
  • Perform a focused neurological assessment
  • Evaluate muscle strength and motor function
  • Administer medications for neurological management
• Cardiopulmonary Emergencies (25)
  • Perform a detailed cardiovascular assessment
  • Identify patients experiencing an acute cardiac event (including acute myocardial infarction, heart failure, cardiogenic shock, primary arrhythmias, hemodynamic instability)
  • Use invasive monitoring during transport, as indicated, for the purpose of clinical management
  • Provide treatment for patients with acute cardiac events and hemodynamic abnormalities
  • Use cardiopulmonary assist devices as part of patient management (including ventricular assist devices, transvenous pacer, intra-aortic balloon pump)
  • Assist in the management of cardiopulmonary assist devices to patient condition as part of patient management (including ventricular assist devices, transvenous pacer, intra-aortic balloon pump)
  • Administer electrical therapies during transport
  • Administer medications for cardiac management
  • Perform a detailed respiratory assessment
  • Identify patients experiencing respiratory compromise (including acute respiratory distress syndrome, spontaneous pneumothorax, pneumonia)
  • Monitor patient’s respiratory status using laboratory values and diagnostic equipment (including pulse oximetry, capnography, blood gas values, chest radiography)
  • Provide treatment for patients with acute respiratory events M. Administer medications for respiratory management
• Toxic and Environmental Exposures (9)
  • Conduct a physical examination of a toxicological patient
  • Decontaminate toxicological patients when indicated
  • Provide emergency care for victims of envenomation (including snake bite, scorpion sting, spider bite)
  • Administer medications intervention (including poison antidotes when indicated)
  • Provide treatment for toxicological patients (including medication overdose, Chemical, Biological, Radiological, Nuclear, and Explosives)
  • Perform an assessment of the patient suffering from an environmental emergency
  • Identify the patient experiencing a cold related emergency (including frostbite, hypothermia, cold water submersion)
  • Identify the patient experiencing a heat related emergency (including heat stroke, heat exhaustion, heat cramps)
  • Identify the patient experiencing a diving related emergency (including decompression sickness, arterial gas emboli, drowning)
  • Identify the patient experiencing an altitude related emergency (including HAPE, cerebral edema)
  • Administer medications for environmental emergency patients
  • Provide treatment of environmental emergencies
• Perinatal and Pediatric Emergencies (19)
  • Perform an assessment of the obstetrical patient
  • Perform fetal assessment
  • Perform electronic fetal monitoring
  • Understand transport considerations of the obstetrical patient
  • Provide treatment for high-risk obstetrical patients
  • Assess uterine contractions
  • Assess cervical status
  • Conduct interventions for obstetrical emergencies (including pregnancy induced hypertension, hypertonic or tetanic contractions, cord prolapse, placental abruption)
  • Assess whether transport can safely be attempted or whether delivery should be accomplished at the referring facility
  • Administer appropriate medications for obstetrical patients
  • Manage precipitous delivery
  • Perform an assessment of the neonatal patient
  • Administer appropriate medications for neonatal patients
  • Implement neonatal resuscitation
  • Manage the neonatal patient during isolette transport
  • Maintain the proper temperature for the neonatal patient
  • Transport neonatal patients receiving specialized ventilatory therapies (including ECMO, nitric oxide, high frequency ventilation)
  • Provide treatment of neonatal emergencies
  • Understand how to care for a neonatal patient experiencing an abnormality (including respiratory, cardiac, congenital defects)
  • Perform an assessment of the pediatric patient
  • Identify the pediatric patient experiencing an acute respiratory event (including epiglottitis, bronchiolitis, asthma)
  • Identify the pediatric patient experiencing an acute medical event (including meningitis, overdose, seizures)
  • Identify the pediatric patient experiencing an acute cardiovascular event (including shock, cardiac anomaly, dysrhythmias)
  • dentify the pediatric patient experiencing an acute traumatic event (including auto v. pedestrian, falls, child abuse)
  • Administer medications for pediatric patients
  • Provide treatment of pediatric emergencies
• Neonates (4)
  • Perform an assessment of the neonatal patient
  • Reevaluate the clinical assessment and management of the neonate when initial emergency measures fail
  • Administer appropriate pharmacology for neonatal patients
  • Implement neonatal resuscitation according to established
  • Manage the isolette transport
  • Provide treatment of neonatal emergencies
• General Medical Patient (10)
  • Perform a focused medical assessment
  • Identify patients experiencing a medical emergency (including AAA, GI bleed, bowel obstruction, HHNC)
  • Use invasive monitoring during transport, as indicated, for the purpose of clinical management
  • Provide treatment for patients with medical emergencies
  • Manage patient condition utilizing available laboratory values (including blood glucose, CBC)
  • Administer medications for the medical patient G. Prevent transmissions of infectious disease
  • Provide pain management
  • Evaluate and record patient pain levels

See also

• International Association of Flight Paramedics
• FlightBridgeED, LLC
• Flight nurse

External links

• Board for Critical Care Transport Paramedic Certification
• Air & Surface Transport Nurses Association