FP-C (Flight Paramedic Certification) is an abbreviation indicating that an individual has attained the designation of Certified Flight Paramedic. The FP-C is an Advanced Certification considered the highest level of academic achievement that a paramedic can get, and the test was designed by the Applied Measurement Professionals to assure compliance with the highest testing standards. This certification is designed to be successfully approved only for experienced master-level paramedics who have demonstrated Advanced knowledge of critical care medicine by passing a 2.5 hour exam consisting of 125 scored items and 10 unscored items. As of May 2016 there are only about 6000 certified flight paramedics worldwide.
The FP-C and/or Critical Care Emergency Medical Transport Program 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 there are review courses and study guides available. The FP-C is considered to be more difficult to obtain than the Critical Care Paramedic Certification (CCP-C) and the Critical Care Emergency Medical Transport Program (CCEMTP) certification, often requiring experience in the air medical / critical care transport field 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 just completed paramedic school are eligible to take the exam and receive certification. In addition, there is no practical skill test associated with the examination (unlike the NRP exam). Many agencies may require prospective employees to demonstrate practical competency in other courses (TPATC, ATLS-audit, CCEMTP, etc.) prior to be 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/PEPP), Pre-Hospital Trauma Life Support (PHTLS/ITLS), and other advanced certifications.
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 absolute 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 that is well above and beyond the basic scope of practice of most licensed paramedics.
Acid-Base Balance
Regulation of acid-base balance
Acid-base derangements
Airway
Rapid Sequence Induction inclusive of standard medications
Intubation and all other airway procedures
Surgical cricothyroidotomy
Needle cricothyroidotomy
Airway medications – their uses, limitations, and contraindications
CAMTS
Flight Following Standards
Proper flight crew uniforms and protective equipment
Minimum crew training and staffing standards
Cardiac
Knowledge of cardiovascular disease and cardiac anomalies
12 Lead Electrocardiogram (ECG or EKG) Interpretations
Cardiac Anatomy/Cardiac Physiology
Cardiac Pharmacology
Thrombolytic Therapy
Understanding of intra-aortic balloon pump (IABP) operation
Mechanics, indications, troubleshooting, and contraindications
Invasive Hemodynamic monitoring / Swan-Ganz catheter interpretation
Arterial lines
Cardiac pacing, synchronized cardioversion, defibrillation, and drugs
Flight Physiology
Knowledge of the gas laws and their effect on patients
Neurological
Treatment/recognition of elevated intracranial pressure, cerebral bleeds, etc.
Neuroprotective agents, vasoactive agents, loop diuretics, etc.
Indications, limitations, and contraindications
Signs and symptoms of head injuries, ICP, cerebral perfusion pressures
Mechanism of Injury and Head Injury dynamics.
OB/Gyn
Fetal circulation
Maternal complications, such as pregnancy induced hypertension.
labor and delivery Complications
Maternal Medications
Pediatric and Neonatal
Pediatric and Neonatal Resuscitation
Physiological differences
Pharmacology
Pediatric assessment
Respiratory and Airway differences
Common Injuries
Anatomical differences
Pediatric psychosocial issues
Non-accidental trauma
Orthopedic injuries
Isolette use
Respiratory
Evaluation of arterial blood gases and treatment for abnormal values
Ventilator settings and parameters
Equipment, uses and troubleshooting
Managing the rapidly deteriorating (decompensation) patient condition
Safety Issues
Part 135 safety issues and flight regulations
AMRM / CRM
Flight Stressors
Aircraft Operations- fixed and rotary wing
Crash safety
Survival issues
Proper safety gear
Stress
Recognizing substance abuse and related issues
Coping with death and dying
Interpersonal relationships
Equipment failures
Thoracic
Signs and symptoms of early versus late cardiac tamponade
Procedures pertaining to thoracic injuries
Needle thoracentesis, pericardiocentesis, thoracostomy tube placement, etc.
Treatment/signs and symptoms of:
Cardiac tamponade, tension pneumothorax, hemothorax, etc.
Trauma
Administration of blood products
Fluid replacement
Injury Dynamics and Predictable Patterns
Define Newton’s 1st, 2nd, & 3rd Laws
Predictable patterns of injury due to mechanisms
Many questions are scenario based with multiple stem questions
Trauma Management (9)
Perform patient triage
Differentiate injury patterns associated with specific mechanisms of injury
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 life-threatening thoracic injuries (e.g., pneumothorax, flail chest, tamponade, myocardial rupture)
Provide care for the patient with abdominal injuries (e.g., diaphragm, liver and spleen)
Provide care for the patient with orthopedic injuries (e.g., pelvic, femur, spinal)
Administer appropriate pharmacology for trauma management
Aircraft Fundamentals, Safety and Survival (12)
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
Participate in crew resource management (CRM)
Participate in flight mission safety decisions (e.g., Go – No Go, abort)
Proper and safe responses to in-flight emergencies (e.g., Aircraft fire, Emergency egress, Emergent landing, Inadvertent changing of weather conditions during flight)
Perform immediate post-accident duties at a crash site
Build survival shelters
Initiate emergency survival procedures
Ensure the safety of all passengers (e.g., specialty teams, family, law enforcement, observer)
Estimate weather conditions that are below weather minimums
CAMTS recommendations
Flight Physiology (10)
Identify causes of hypoxia
Take corrective measures to prevent altitude related hypoxia
Identify signs of barometric trauma
Identify stressors related to transport (e.g., 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
Relate the stages of hypoxia 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 Management Techniques (5)
Identify the indications for basic and advanced airway management
Identify the indications and contraindications for specific airway interventions
Perform advanced airway management techniques
Administer appropriate pharmacology for airway management (e.g., Rapid Sequence Induction, post intubation sedation)
Implement a failed airway algorithm
Identify esophageal intubation
React to intubation complications
Perform alternative airway management techniques (e.g., needle cricothyrotomy, surgical cricothyotomy, Seldinger technique, retrograde intubation, LMA)
Monitor airway management and ventilation during transport
Use mechanical ventilation
Neurological Emergencies (10)
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 a baseline neurologic assessment of a trauma patient
Perform an ongoing serial evaluation of a neurologic patient
Assess changes in intracranial pressure using patient level of consciousness
Perform a focused neurological assessment
Assess a patient using the Glasgow coma scale
Manage patients with head injuries
Manage patients with spinal cord injuries
Evaluate muscle strength and motor function
Administer appropriate pharmacology for neurological management
Critical Cardiac Patient (20)
Perform a detailed cardiovascular assessment
Identify patients experiencing an acute cardiac event (e.g., 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
Control cardiopulmonary support devices to patient condition as part of patient management (e.g., ventricular assist devices, transvenous pacer, intra-aortic balloon pump)
Assist in the control of cardiopulmonary support devices to patient condition as part of patient management (e.g., ventricular assist devices, transvenous pacer, intra-aortic balloon pump)
Conduct defibrillation during transport
Administer appropriate pharmacology for cardiac management
Respiratory Patient (10)
Perform a detailed respiratory assessment
Identify patients experiencing respiratory compromise (e.g., acute respiratory distress syndrome, spontaneous pneumothorax, pneumonia)
Monitor patient’s respiratory status using laboratory values and diagnostic equipment (e.g., pulse oximetry, capnography, blood gas values, chest radiography)
Provide treatment for patients with acute respiratory events
Administer appropriate pharmacology for respiratory management
Toxic Exposures (6)
Conduct a physical examination of a toxicological patient
Decontaminate toxicological patients when indicated
Administer poison antidotes when indicated
Provide emergency care for victims of envenomation (e.g., snake bite, scorpion sting, spider bite)
Administer appropriate pharmacology for toxic exposures
Provide treatment for toxicological patients (e.g., medication overdose, chemical/biological/radiological exposure)
Obstetrical Emergencies (4)
Perform an assessment of the obstetrical patient
Perform fetal assessment
React to special transport considerations of the obstetrical patient
Provide treatment for high-risk obstetrical patients
Assess uterine contractions
Conduct interventions for obstetrical emergencies (e.g., pregnancy induced hypertension, hypertonic or titanic contractions, cord prolapse, placental abruption)
Assess whether transport can safely be attempted or whether delivery should be accomplished at the referring facility
Administer appropriate pharmacology for obstetrical patients
Manage emergent delivery
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
Pediatric (10)
Perform an assessment of the pediatric patient
Identify the pediatric patient experiencing an acute respiratory event (e.g., epiglottitis, bronchiolitis, asthma) C. Identify the pediatric patient experiencing an acute medical event (e.g., meningitis, overdose, seizures)
Identify the pediatric patient experiencing an acute cardiovascular event (e.g., shock, cardiac anomaly, dysrhythmias)
Identify the pediatric patient experiencing an acute traumatic event (e.g., auto v. pedestrian, falls, child abuse) F. Administer appropriate pharmacology for pediatric patients
Provide treatment of pediatric emergencies
Burn Patients (5)
Perform an assessment of the burn patient
Calculate the percentage of total body surface area burned
Calculate appropriate fluid replacement amounts based on the patient’s burn injury and physiologic condition D. Diagnose inhalation injuries in burn injury patients
Administer appropriate pharmacology for burn patients
Provide treatment of burn emergencies
General Medical Patient (16)
Perform a focused medical assessment
Identify patients experiencing a medical emergency (e.g., Abdominal Aortic Aneurysm, GI bleed, bowel obstruction, HHNC (Hyperosmolar Hyperglycemic Non-Ketotic Coma)
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 (e.g., blood glucose, CBC, H/H)
Administer appropriate pharmacology for the medical patient
Prevent transmissions of infectious disease
Provide appropriate pain management
Evaluate and record patient pain levels
Environmental (4)
Perform an assessment of the patient suffering from an environmental emergency
Identify the patient experiencing a cold related emergency (e.g., frostbite, hypothermia, cold water submersion)
Identify the patient experiencing a heat related emergency (e.g., heat stroke, heat exhaustion, heat cramps)
Identify the patient experiencing a diving related emergency (e.g., decompression sickness, arterial gas emboli, near drowning)
Identify the patient experiencing an altitude related emergency (e.g., HAPE, cerebral edema)
Administer appropriate pharmacology for environmental emergency patients
Provide treatment of environmental emergencies practice
Acid/Base Balance
Understand fundamentals of Acid/Base balance in the body
Understand affects of Acid/Base balance disturbances and their effects in the body
