CCAT Advanced Course Information Packet
Transcription
CCAT Advanced Course Information Packet
C R I T I C A L C A R E A I R T R A N S P O RT ( C C AT ) A D VA N C E D C O U R S E Center For Sustainment of Trauma and Readiness Skills (CSTARS), Cincinnati OH VERSION 5: 23 JUNE 2015 Page 1 of 31 CCATT ADVANCED COURSE INFORMATION PACKET Table of Contents Location ................................................................................................................................................................. 4 Course Description ................................................................................................................................................ 4 Continuing Education ........................................................................................................................................... 4 Physicians: ......................................................................................................................................................... 4 Nurses: ................................................................................................................................................................ 4 Respiratory Therapists: .................................................................................................................................... 5 Emergency Medical Technicians ...................................................................................................................... 5 Prerequisites .......................................................................................................................................................... 5 University Application/Credentialing Process ..................................................................................................... 5 Requirements ......................................................................................................................................................... 5 Documentation: ................................................................................................................................................. 5 Flight Surgeons End of Course Training Flight - Logging Flight Time ........................................................ 6 Active Flight Surgeons .................................................................................................................................... 6 In-Active Flight Surgeons (API-0) .................................................................................................................. 6 Uniform .............................................................................................................................................................. 6 Flight Safety Requirements ............................................................................................................................. 7 Military Bearing .................................................................................................................................................... 7 Generating TDY Orders ....................................................................................................................................... 7 Info For All Active Duty Air Force Members: ................................................................................................ 7 Info For Reserve, Guard & Non-Air Force Active Duty Members: .............................................................. 8 Info Pertaining To All: ....................................................................................................................................... 8 Student Lodging Information .............................................................................................................................. 8 Per Diem Rate .................................................................................................................................................... 8 Transportation To and From Class: ................................................................................................................. 8 UC Medical Campus Map ................................................................................................................................ 9 Travel/Transportation ........................................................................................................................................... 9 Government Travel Card .................................................................................................................................. 9 Taxicab Service from CVG ............................................................................................................................. 10 Executive Transportation ................................................................................................................................ 10 VERSION 5: 23 JUNE 2015 Page 2 of 31 CCATT ADVANCED COURSE INFORMATION PACKET Departing Instructions ........................................................................................................................................ 10 Attachments ......................................................................................................................................................... 10 1. Sample Course Schedule ........................................................................................................................ 10 2. CCAT Team Candidate Skill Validation Process ................................................................................... 10 3. Request for Non-Interference Aeronautical Orders. Open the to fill this form out electronically ......... 10 4. UC Medical Campus Map ...................................................................................................................... 10 5. Memorandum: Cardiopulmonary Competency Proficiency Assessment ............................................... 10 6. Flight/Jump TDY Worksheet .................................................................................................................. 11 7. Welcome Letter....................................................................................................................................... 11 Email The Course NCOIC VERSION 5: 23 JUNE 2015 Page 3 of 31 CCATT ADVANCED COURSE INFORMATION PACKET C C AT A D VA N C E D COURSE Course Information Packet CSTARS Home Page Location The CCAT Advanced Course is taught by the staff of CSTARS Cincinnati, located within the Division of Trauma and Critical Care at the University of Cincinnati Medical Center. Division of Trauma and Critical Care is part of the University of Cincinnati Medical Center Department of Surgery and serves the tri-state region of Southwest Ohio. It is also a verified regional Burn Center and is the only Level One Adult Trauma Center in the area. Course Description This 14-day course is composed of 12 days of clinical/didactic/simulator/flight exercise activities plus travel days and is designed specifically for personnel assigned to CCAT Team UTC’s. The emphasis is on the transport of the critical care patient by air, along with didactics on the air-evacuation system, culminating in a field exercise involving a flight on an AC-130 aircraft. Personnel rotate in the intensive care units of the Medical Center, a multidisciplinary 34 bed unit with over 3000 patient encounters each year. They function as the primary providers for critically ill and injured patients under the tutelage of both civilian and military faculty. The physicians complete clinical duties including nighttime call responsibilities in the Surgical Intensive Care Unit. The nurses and respiratory therapists complete clinical duties primarily in the Surgical and Neuro Intensive Care Units. Respiratory Therapists may refer to attachment 5: Cardiopulmonary Competency Proficiency Assessment for assistance with course preparation. In addition there are approximately 20 hours of AFSC/UTC specific lessons. This course enables the student to complete the AFSC specific RSV's and the CCAT Team sustainment training items. The course is designed to meet 100% of the RSV's for the individuals assigned to a CCAT Team UTC. An example copy of the daily course schedule may be found at attachment 1. A welcome letter from Dr. Michael Petro, MD, Director CSTARS Course may be found at attachment 7. Continuing Education Physicians: Continuing Medical Education will be made available via HQ AFPC/DPANE. https://education.mods.army.mil/airforcecme/ Nurses: Continuing Nursing Education will be made via HQ AFPC/DPAMN. https://education.mods.army.mil/afncne/ VERSION 5: 23 JUNE 2015 Page 4 of 31 CCATT ADVANCED COURSE INFORMATION PACKET Respiratory Therapists: The American Association of Respiratory Care (AARC) has approved this activity. Due to recent budget constraints, CRCEs are currently not available. AARC Website Link Emergency Medical Technicians The Air Force Emergency Medical Technician (EMT) Program Manager has approved this activity. EMTs receive a maximum of 48.0 hours for recertification. Prerequisites Course participants must be assigned to, or nominated for assignment to, a CCAT Team UTC and must have completed the CCAT Initial Course at Wright-Patterson AFB, OH (B3OZYCCATT-001). All 4H0X1s will attend training at C-STARS Cincinnati regardless of UTC placement. Course participants must have undergone the CCAT Skill Validation Process IAW AFI 41-106 and have received a Clinical Validation Committee (CVC) approval letter prior to attending the course. Refer to attachment 2: CCAT Team Candidate Skill Validation Process for information on the CVC process. Please call AFEMSI at (937) 938-3218 DSN 798-3218 with questions or concerns regarding the CVC process. Download AFTTP 3-42.51 here. University Application/Credentialing Process Applications/credentialing packages for all personnel attending the CCAT Advanced Course will be handled by AFEMSI at Wright-Patterson Air Force Base (WPAFB), OH. Once you have been identified to attend the course, an AFEMSI credentialing specialist will contact you via email to assist with completing and submitting required paperwork. Please pay particular attention to drop-dead dates as the civilian Universities will NOT provide extensions. NOTE: The application/credentialing package/process is different from the CCAT skill validation application/nomination package/process. Some documentation may be the same; however, they are two different processes. Requirements Documentation: 1. Non-Interference Aeronautical Orders (AO). All CCAT Team UTC personnel should have established a flight record with their home station Host Aviation Resource Management (HARM) VERSION 5: 23 JUNE 2015 Page 5 of 31 CCATT ADVANCED COURSE INFORMATION PACKET Office, or Squadron Aviation Resource Management (SARM) Office, immediately upon return from the CCAT Initial Course. If you have not done so, do so immediately. You must bring a copy of non-interference AOs to the course. Non-interference AOs are required for the end of course training flight. Request the AOs from your HARM/SARM well prior to your departure date for the course. A sample non-interference AO request can be found at attachment 3. Flight Surgeons End of Course Training Flight - Logging Flight Time Active Flight Surgeons In order for active flight surgeons to log “FS” time during the training flight, the following requirements must be met: 1. Complete Flight/Jump TDY Worksheet (print from AFI 11-421 or see attachment 6 2. Copy of Active AO's: ASC 8A 3. Copy of current AF Form 1042 (physical form) 4. Copy of current AF Form 702 (altitude chamber form) 5. Copy of ARMS Individual Data Summary (IDS) 6. Copy of ARMS Flying History Report (FHR) 7. Copy of ARMS Individual Training Summary (ITS) 8. Must be current in Flight Surgeon Exam, CRM, Emergency Egress Procedures, 60-Day FS currency and/or any other applicable AFI 11-2MDS Vol 1 requirements. NOTE: It is the member's responsibility to contact the TDY HARM/SARM for the flying unit supporting the training flight, prior to flight, to confirm currency/grounding requirements. Non-current active flight surgeons will not be allowed to log flight time. In-Active Flight Surgeons (API-0) Inactive flight surgeons will not log time during the training flight. Inactive flight surgeons will have Non-Interference Aeronautical Orders to participate in the end-of-course training flight (see “Requirements” “Documentation” “1” above). Uniform Day One uniform requirement is the Flight Suit or ABUs (if you do not have one, work with your unit to obtain one as this is a requirement for flight operations at the course; ref: AFTTP 3-42.51). Flight suit or ABUs are required for the field/training flight exercise and Air Care fly-along. You will also need to bring work/flight gloves (mandatory). VERSION 5: 23 JUNE 2015 Page 6 of 31 CCATT ADVANCED COURSE INFORMATION PACKET Flight Safety Requirements The wearing of rings, watches, ID bracelets, or other metallic jewelry or accouterments during the field exercise is prohibited. In addition, underwear and undergarments must be pure cotton and non- conductive. Students must also have dog tags to participate in the flight field exercise. Bring a jacket regardless of the time of year; remember it is cold at altitude. Flight gloves or equivalent are also mandatory. ALL Personnel need to bring scrubs with them for clinical duties, preferably conservative in color-no prints. Bring extra military pin-on nametag and pin-on rank to wear on scrubs, reference AFI 362903. SCRUBS ARE NOT SUPPLIED FOR YOU. ALL Personnel need to bring the necessary clinical tools needed to provide patient care (i.e. stethoscope, reference material, head-lamp for simulations). THESE ITEMS ARE NOT PROVIDED FOR YOU. We recommend that you bring a pair of conservative tennis shoes, clogs, or other appropriate foot wear to be worn with scrubs while performing your clinical duties. Open toe shoes/sandals are not permitted while on duty. Click here to check local weather. Military Bearing University of Cincinnati Medical Center is a civilian institution. During your attendance, remember you are a member and representative of the US Armed Services and subject to regulations regarding appearance, fraternization, and behavior. Expect occasional visitors from the Pentagon, Surgeon General’s office, Air Force Reserve Command (AFRC) and the National Guard Bureau as well as distinguished civilian visitors. Address fellow team members and faculty by proper military titles and civilian staff by “Mr./Ms./Dr.” Exercise good judgment when choosing off duty activities. Generating TDY Orders Finance office should not de-commit off AF 616 listed. Orders crossing Fiscal Years (FY) must include both FY fund cites. Info For All Active Duty Air Force Members: The CCAT Advanced Course is a centrally funded AFMS course. You will receive a training Report on Individual Personnel (RIP). Typically, the training RIP flows from your formal training office. Embedded in your formal training RIP are instructions on returning the RIP to the 711HPW finance department. A scanned copy (in Word or .pdf format) of your training RIP MUST be emailed to: 711HPWTDYToSchool@wpafb.af.mil. Once your training RIP is returned, the 711HPW finance department will establish a line of accounting to be used as a funding source for your TDY. Your institution should have a DTS expert that can assist you. VERSION 5: 23 JUNE 2015 Page 7 of 31 CCATT ADVANCED COURSE INFORMATION PACKET Info For Reserve, Guard & Non-Air Force Active Duty Members: The CCAT Advanced Course is a centrally funded AFMS course for ANG members. The CCAT Advanced Course is a unit funded AFMS course for Air Force Reserve and non-Air Force members. You must work through your Unit Training Manager (UTM) for course scheduling. For AFRC personnel, your UTM MUST contact HQ AFRC/SGS Formal Training Manager at Commercial 478-327-1903 or DSN 497-1903; for ANG personnel, your UTM MUST contact USAF ANG NGB Formal Training Manager at Commercial 301-836-8325 or DSN 278-8325; PRIOR TO scheduling with Air Force Expeditionary Medical Skills Institute (AFEMSI). Once selected for training, you will receive a training RIP. Typically, the training RIP flows from your Formal Training Office. Once you receive your training RIP, you may create your TDY Orders. Your institution should have a DTS/AROWS expert that can assist you. Info Pertaining To All: Your approved TDY Orders MUST have a 6 digit alphanumeric Travel Order Number in Block 22 (if your TDY Orders do NOT have a Block 22 but lists a Travel Auth Number in the upper right hand corner, this MUST contain a 6 digit alphanumeric value). TDY Orders created in AROWS for ANG/ AFRC members will not contain this number. Student Lodging Information The training site arranges lodging for the CCAT Advanced Course. For questions regarding lodging, contact the CSTARS Cincinnati Administrator, (513) 584-0330/0331. A member of the C-STARS Cincinnati Administrative staff will contact you via email with lodging instructions. If your start date is approaching and you haven’t been contacted, please call CSTARS at (513) 584-0330/0331 to confirm the location of your lodging. If applicable, dual lodging is authorized during flight duty IAW JFTR Chapter 4 Sec U4125 Para A1I. A copy of your travel orders MUST be faxed PRIOR to class to DSN 674-6292 or Commercial 937-904-6292. Per Diem Rate Per Diem rates are full, meal tickets are no longer provided. For additional information on Per Diem rates, please visit the website listed below. http://www.defensetravel.dod.mil/site/perdiemCalc.cfm Transportation To and From Class: Two GOV’s (vans) are provided for student transportation use. The keys for the vans will be at the front desk of the hotel you are staying at. Parking for the vans while in class will be at the hotel. VERSION 5: 23 JUNE 2015 Page 8 of 31 CCATT ADVANCED COURSE INFORMATION PACKET UC Medical Campus Map A map of the medical campus may be found at attachment 4 Travel/Transportation Government Travel Card Prior to your departure be sure that your Government Credit Card has been activated by your orderly room personnel to allow you to take cash advances. Also, ensure that your cash advance limit is set to at least $500.00. Website: https://home.cards.citidirect.com/CommercialCard/Cards.html Individuals traveling by commercial air should make arrangements to arrive at the Greater CincinnatiKentucky International (CVG) Airport. Baggage handling tips are NOT authorized. Excess baggage charges are NOT authorized. ATM charges, if used, must NOT exceed a total of $20.00 for the duration of the class. Greater Cincinnati Kentucky Airport Website Google map of local area POV: Individuals traveling by POV should park at the hotel where complimentary parking is provided. . GOV: 2 GOV vans are available for the students to utilize. Rental Cars: Rental cars are NOT authorized for reimbursement. If you do decide to pay for a rental car out of pocket, here are the major companies to rent from: Rental Cars (888) 826-6893 www.alamo.com (800) 331-1212 www.avis.com (800) 325-8007 www.pickenterprise.com (800) 527-0700 www.budgetrentacar.com (800) 654-3131 www.hertz.com (800) 328-4567 www.nationalcar.com VERSION 5: 23 JUNE 2015 Page 9 of 31 CCATT ADVANCED COURSE INFORMATION PACKET Taxi: Students arriving by air at Cincinnati-Kentucky International Airport may take a taxi to site, the cost is approximately $30-$40. Taxis may NOT take government credit cards so please plan accordingly. Taxicab Service from CVG For cab service, visit the taxi desk in Terminal 3 bag claim or use the courtesy phone in Terminal 2 bag claim. • Approximately $30 fares from CVG to downtown Cincinnati • Call for rates to other area locations • Service is available 24 hours a day • Call (859)-767-3260 for more information Executive Transportation Provides service to hotels, attractions and other locations throughout the region. • Approximately $22 to Downtown or Covington, $32 round-trip • Call for rates to other area locations • Walk-up service welcome, call to guarantee reservation • Service available via shuttle desks in bag claim areas • Van or limousine service also available • Reserve a private coach for large groups • Call (859)-261-8841, (800)-990-8841 or visit online Departing Instructions Do NOT make departure plans on the last day of class due to Final Testing until approximately 1800 hrs. Individuals should plan their departure travel on Saturday. NOTE: Credit card required upon check in for incidentals only. Students will not be charged for their room as it is paid under contract. If there are any questions contact 513-584-0331/0330. Attachments (Click on the links below to open the specific attachment) 1. Sample Course Schedule 2. CCAT Team Candidate Skill Validation Process 3. Request for Non-Interference Aeronautical Orders. Open the to fill this form out electronically 4. UC Medical Campus Map 5. Memorandum: Cardiopulmonary Competency Proficiency Assessment VERSION 5: 23 JUNE 2015 Page 10 of 31 CCATT ADVANCED COURSE INFORMATION PACKET 6. Flight/Jump TDY Worksheet 7. Welcome Letter VERSION 5: 23 JUNE 2015 Page 11 of 31 CCATT ADVANCED COURSE INFORMATION PACKET ATTACHMENT 1: SAMPLE COURSE SCHEDULE DOT 1 13 Aug Monday DOT 2 14 Aug Tuesday DOT 3 15 Aug Wednesday DOT 4 16 Aug Thursday DOT 5 17 Aug Friday DOT 6 18 Aug Saturday UOD Flt Suit/ABU Scrubs Scrubs Scrubs Scrubs Scrubs 1700-2300 Air Care No Clinical Assignments 1700-2300 Air Care 1700-2300 Air Care 1700-2300 Air Care 1700-2300 Air Care 0700-1500 1500-2300 Air Care **EMEDS starts 30 min prior to SIM** 0700-1500 RN/RT Clinical 0700-1500 RN/RT Clinical 0730-1330 CCATT Intro to SIM 0800-0900 CCATT VTC (MDs) 0800-1000 RT Test 2- PMI TEST 1 0800-1100 MD Clinical - Table Top Resuscitation 0645 Meet in Hotel Lobby 0700-0830 Staff Introductions 0630-0730 End Points of Resuscitation 0730-0820 Thoracic Trauma C-STARS Introduction Brief Admin Update 0830-0930 Team/AFSC Expectations 0930-1030 Hospital In-Processing, Orientation & Tour/Meti Orientation 1030-1130 Initial Priorities in the Trauma Patient 1130-1215 Lunch Class Photo/Aircraft Safety Video 1215-1305 Blood/Blood Component Therapy 1315-1415 Abdominal Trauma 1430-1730 PMI Exercise IVAC, 754 Vent, TBI, Defib, Allowance Standard VERSION 5: 23 JUNE 2015 0830-0920 Extremity Trauma External Fixation 0930-1020 Catastrophic Brain Tabletop 3- Knowledge Assessment/Initial Efficacy 1330-1450 ACLS Update/Sedation & Analgesia 1030-1230 Preflight Packaging Exercise 1500-1620 TBI/Spinal Injury 1230-1300 Lunch 1630-1800 Codman Advanced Lab 1300 -1500 AS review Propaq, Suction, LTV Vent, VSB, Smeed, Allowance Standard 1500-1630 Clinical Skills Bag Valve Mask Nasal/Oral Intubation Tube Xchange Catheter LMA Cricothyrotomy Needle thoracostomy Tube thoracostomy 0800-1000 MD Clinical - Table Top Neuro Trauma/TBI 0700-0800 CCATT/AE Primer AE Systems/Aircraft Overview 0800- 0900 Aircraft & Flightline Safety Artificial Intelligence **EMEDS starts 30 min prior to SIM** CCATT SIM 1 Review 1000-1100 Alpha 1100-1200 Bravo 1200-1300 Charlie 1300-1400 Delta 1400-1500 Echo CCATT SIM TEST 1 TCCET SIM 1000-1030 Tactical Casevac 1500-1530 Test Review 1100-1130 Stresses of Flight/CRM 1530-1700 CCATT RODEO 1130-1230 Infection Control 1100-1200 MD Trauma Conference 0800-0930 0930-1100 1100-1230 1230-1400 1400-1530 Alpha Bravo Charlie Delta Echo 0900-1000 Flight Line Safety Life Support 1530-1630 ALI/ARDS/Protective Ventilation Strategies 1630-1730 Impact 754 Ventilator LTV 1000 Advanced Lab Page 12 of 31 CCATT ADVANCED COURSE INFORMATION PACKET DOT 7 19 Aug Sunday DOT 8 20 Aug Monday DOT 9 21 Aug Tuesday DOT 10 22 Aug Wednesday DOT 11 23 Aug Thursday DOT 12 24 Aug Friday Scrubs Scrubs Scrubs Scrubs Flight Suits Flight Suits 1500-2300 Optional Clinical Assignments 1700-2300 Air Care 1700-2300 Air Care 1700-2100 Air Care No Clinical Assignments No Air Care No Clinical Assignments No Air Care 0730-0815 AE Lecture/Test 0700-1500 RN/RT Clinical 0700-1430 RN/RT Clinical Alerted for Mission Meet in hotel lobby, travel TBD 0730-1500 University Hospital SIM Center 0815-0915 Documentation/PI 0800-1200 MD Clinical - Table Top Burn Resuscitation 0800-1000 MD Clinical - Table Top Mechanical Ventilation **EMEDS starts 30 min prior to SIM** 1000-1100 TCCET SIM Time TBD Mission/Patient Preparation/CCATT Mission Preparation/ Litter Loading 1- Knowledge Assessment USAFSAM EOC Survey CME/CNE Eval DOT-12 Efficacy 0915-1045 Trauma in Special Populations – Pediatrics, Pregnancy and Advanced Age- Disaster Relief 1045-1145 Epidural/Ambit PCA 1145-1230 Lunch 1230-1330 PMI Review/CCATT Tricks of the Trade/PCA Pump 1330-1415 Acute Coronary Syndrome 1415-1530 Thermal Injury/Burn CCATT SIM TEST 2 0800-0930 0930-1100 1100-1230 1230-1400 1400-1530 Echo Delta Charlie Bravo Alpha 1530-1630 CCATT Jeopardy 1330-1430 (RN only) Patient Presentation 1430-1530 Oxygen Calcs/ISTAT 1530-1630 CCATT Patient Briefing AS/PMI Preparation/loading **Have inventory allowance standard in cadre office NLT 0700 23 Aug** Time TBD Flight Time TBD CCATT Debrief **EMEDS starts 30 min prior to SIM** 2- CCATT SIM TEST 3 3- PMI Test 2 1500-1530 Test Review 1530-1630 Individual Performance Reviews 1630-1700 CCATT Graduation 1530-1630 Critical Incident Lecture VERSION 5: 23 JUNE 2015 Page 13 of 31 CCATT ADVANCED COURSE INFORMATION PACKET ATTACHMENT 2: CCATT CANDIDATE SKILL VALIDATION PROCESS Critical Care Air Transport (CCAT) Team Candidate Selection & Validation IAW AFI 41-106, para 6.4.7., all active duty and Air Reserve Component (ARC) members nominated by their commander for CCAT team duty will undergo a position-specific skill validation process administered by AFEMSI under the authority of AMC/SG, the CCAT MRA. Candidates for CCAT UTC membership must be world-wide qualified and able to meet the requirements for physician, nurse, or respiratory therapy technician positions as set forth below. They must be able to obtain Operational Support Flier status IAW AFI 11-402, Aviation and Parachutist Service, Aeronautical Ratings and Badges, obtain an official government passport, and have a minimum of a Secret security clearance. Unit commanders are responsible for selecting, training, and preparing members for assignment to UTCs FFCCT, FFCCE, and FFCCN. The CCAT validation process does not remove these responsibilities from the commander. The process is an enhancement to the medical UTC assignment system to ensure that only the most highly skilled medical professionals are assigned to CCAT UTCs. All individuals selected by commanders as candidates for UTCs FFCCT, FFCCE, and FFCCN duty will undergo a position-specific validation process administered by Air Force Expeditionary Medical Skills Institute (AFEMSI), under the authority of HQ AMC/SG as the MRA for CCAT. The validation process must be completed for all candidates prior to attending the CCAT Advanced Course. (The CCAT Initial Course is an open course; validation is preferred prior to attending the CCAT Initial Course, but not required.) The CCAT validation process will assist MTF commanders in their responsibility to assign only those individuals with the requisite skills and experience to a CCAT UTC. The validation process is also designed to assist commanders in determining what further experience and training a prospective CCAT candidate must obtain in order to capably perform the CCAT mission. Validation reviews will be conducted expeditiously in order to avoid delays in a commander’s ability to make timely personnel assignments to a CCAT UTC. Selection. Review packages must be prepared for each proposed CCAT UTC candidate nominated by the unit commander. Forward complete packages to AFEMSI for review and validation. (A skill validation process flow chart is included as Attachment 1. A sample application submission cover letter is included as Attachment 2.) The address for AFEMSI is: USAFSAM/ETS Wright-Patterson AFB, Ohio 45433 DSN 986-8476, CML 937-656-8476 Subject Line: “CCAT CVC Application for (Candidate’s Name)” VERSION 5: 23 JUNE 2015 Page 14 of 31 CCATT ADVANCED COURSE INFORMATION PACKET Clinical Validation Committee. A Clinical Validation Committee (CVC) composed of experienced CCAT members will review packages for recommended nominees. When reviewing candidates from Air Force Reserve Command (AFRC) or the Air National Guard (ANG), a qualified physician, critical care nurse, or respiratory technician representative from the respective component, as applicable, will be a member of the CCAT CVC for the reserve member. Members of the CVC may not be in a CCAT UTC candidate’s direct chain of command. A lead reviewer will be appointed in each CVC. A structured interview of the proposed member will be accomplished by the CVC lead. Two additional CVC members will review the package concurrently. Validation status will be assigned by a consensus of the three CVC members. AFEMSI will appoint a CVC Medical Director to lead the review process. The CVC Medical Director will be responsible for assigning CVC members and the clinical skills review process. Any irresolvable conflicts between the CVC members will be referred to the CVC Medical Director. The validation process will be completed within a 2-week period, with expedited review for ARC candidates to prevent a delay in the accession process. Based on the committee’s decision, a candidate will be assigned one of the following: Approved – Allows candidate immediate assignment to a CCAT UTC and admission to the CCAT training pipeline. Provisional – Awaiting additional information on candidate or additional training/experience is required. This status will be changed to “approved” once additional verified information is received and/or additional training/experience is accomplished. If additional training is required, a training plan will be issued to the individual and his/her home unit by AFEMSI. Members may not be assigned to the UTC while in “provisional” status; all provisional items must be satisfactorily completed before “approved” status is designated. Personnel on provisional status will not be admitted to the CCAT Initial Course until “approved” status is designated. Once the training plan is completed, the candidate’s home unit will forward documentation of completion to AFEMSI. AFEMSI will review the completed training plan prior to changing member status to “approved.” Failure to complete provisional items within six months will result in “disapproved” status. Disapproved – Candidate does not meet eligibility requirements for assignment to a CCAT UTC. "Disapproved" applicants may appeal the decision through their unit commander to HQ AMC/SG (the CCAT MRA and appeal decision authority). The appeal package must include the original selection package, a letter of rebuttal to the disapproval, and any additional supporting documentation. (See Attachment 3 for sample letter of rebuttal). CCAT UTC Candidate Application Package Contents. Physician. Physician selection review package requires (see Attachment 4 for sample package layout): VERSION 5: 23 JUNE 2015 Page 15 of 31 CCATT ADVANCED COURSE INFORMATION PACKET a. Current curriculum vitae including a statement of attestation from the candidate affirming the total number of hours of critical care patient management for the past two years. (Critical care patient management experience is defined as patient care requiring continuous cardiac and/or invasive hemodynamic monitoring and/or advanced airway support/management.) 800 hours of critical care patient management is the desired minimum requirement, however, personnel with less than 800 hours can apply for CCAT UTC duties and should attest to the total number of critical care patient management hours they have at the time of application. b. Current Hospital Privilege List (AF Form 1562 or equivalent) c. Current copies of medical license(s), Basic Life Support (BLS), and Advanced Cardiac Life Support (ACLS). One-time Advanced Trauma Life Support (ATLS) course and on-going contemporary clinical experience is required. Current ATLS course is desired; current Pediatric Advanced Life Support (PALS) course is desired for FFCCT. Current PALS course is required for FFCCN. d. Current copy of 44Y3 Readiness Skills Verification (RSV) checklist for FFCCT position; or, copy of 44K3E RSV checklist for FFCCN position. Nurse. Nurse selection review package requires (see Attachment 5 for sample package layout): a. AFSC: 46N3E, 46N3J, or 46Y3M with current critical care experience. b. Current curriculum vitae including a statement of attestation from the candidate affirming the total number of hours of critical care patient management for the past two years. (Critical care patient management experience is defined as patient care requiring continuous cardiac and/or invasive hemodynamic monitoring and/or advanced airway support/management.) 800 hours of critical care patient management is the desired minimum requirement, however, personnel with less than 800 hours can apply for CCAT team duties and should attest to the total number of critical care patient management hours they have at the time of application. c. Current nursing job description and 2 references. d. Current copies of nursing license(s), BLS, and ACLS. (PALS, Adult Critical Care Nursing {CCRN}, Trauma Nursing Core Course {TNCC}, and Advanced Trauma Care for Nurses {ATCN} certification is recommended, but not required. If certification in these areas is held, please include as applicable.) VERSION 5: 23 JUNE 2015 Page 16 of 31 CCATT ADVANCED COURSE INFORMATION PACKET e. Current copy of 46N3E RSV checklist for UTC FFCCT or FFCCE position; or copy of 46N3F RSV checklist for UTC FFCCN position. 46Y3M will submit current copy of RSV checklist for that AFSC. Respiratory Therapist. Respiratory therapist package requires: (see Attachment 6 for sample package layout): a. Documentation of current 5-skill level or higher. b. Current curriculum vitae including a statement of attestation from the candidate affirming the total number of hours of critical care patient management for the past two years. (Critical care patient management experience is defined as patient care requiring continuous cardiac and/or invasive hemodynamic monitoring and/or advanced airway support/management.) 800 hours of critical care patient management is the desired minimum requirement, however, personnel with less than 800 hours can apply for CCAT team duties and should attest to the total number of critical care management hours they have at the time of application. c. Certified Respiratory Therapist (CRT) eligible; CRT status preferred. Registry status encouraged. d. Current copies of respiratory license, BLS, and ACLS. e. Current copy of RSV checklist. VERSION 5: 23 JUNE 2015 Page 17 of 31 CCATT ADVANCED COURSE INFORMATION PACKET CCAT Team Skill Validation Process Flowchart VERSION 5: 23 JUNE 2015 Page 18 of 31 CCATT ADVANCED COURSE INFORMATION PACKET SAMPLE COVER LETTER FOR SELECTION REVIEW PACKAGES FOR CCATT CANDIDATES (Date) MEMORANDUM FOR USAFSAM/ETS CCATT CLINICAL VALIDATION COMMITTEE (Address) FROM: (UNIT OF ASSIGNMENT/CC or designated representative) (Address) SUBJECT: Nomination for CCATT UTC Assignment – (Member Rank, Name) 1. (Rank, Name, AFSC) is presently assigned to the (unit of assignment) and is nominated for appointment to a CCATT Unit Type Code (UTC). The member meets all standards and requirements for this appointment as set forth in AFTTP 3-42.51, AFI 41-106, and AFI 11-402. 2. Documentation is attached to this request to verify member’s qualification/experience. Request review of the selection package, and concurrence on member’s appointment to a CCATT UTC. 3. My POC for this request is (Rank, Name, email address, DSN or commercial phone number). (Signature) TYPED NAME, Grade, USAF, CORPS Commander or designated representative Attachment(s): (List supporting documentation) VERSION 5: 23 JUNE 2015 Page 19 of 31 CCATT ADVANCED COURSE INFORMATION PACKET SAMPLE LETTER OF REBUTTAL (Date) MEMORANDUM FOR HQ AMC/SG (Address) FROM: (UNIT OF ASSIGNMENT/CC) (Address) SUBJECT: Letter of Rebuttal: Member Disapproved for CCATT Selection – (Member Rank, Name) 1. (Rank, Name, AFSC) is presently assigned to the (unit of assignment) and was nominated for appointment to a CCATT Unit Type Code (UTC). Member was deemed acceptable for appointment to CCATT and a selection review package was forwarded to the Air Force Expeditionary Medical Skills Institute (AFEMSI) for formal consideration by the CCATT Clinical Validation Committee. 2. On (date), I received notice from the CCATT Clinical Validation Committee that the member was disapproved for appointment to a CCATT UTC. I am writing to respectfully protest the disapproval. 3. (Provide sufficient justification to reverse/amend the disapproval. Attach additional documentation.) 4. Request your review and consideration to approve member for appointment to CCATT. (Signature) TYPED NAME, Grade, USAF, CORPS Commander Attachment(s): (List supporting documentation) cc: USAFSAM/ETS VERSION 5: 23 JUNE 2015 Page 20 of 31 CCATT ADVANCED COURSE INFORMATION PACKET SAMPLE CCATT PHYSICIAN SELECTION REVIEW PACKAGE Cover Letter Statement of attestation from the member affirming 800 hours of active critical care patient management Curriculum Vitae Hospital Privilege List (AF Fm 1562 or equivalent) Medical License(s) BLS certificate ACLS certificate ATLS certification (or equivalent clinical experience) PALS certification (if applicable - desired only) Readiness Skills Verification checklist VERSION 5: 23 JUNE 2015 Page 21 of 31 CCATT ADVANCED COURSE INFORMATION PACKET SAMPLE CCATT NURSE SELECTION REVIEW PACKAGE Cover Letter Statement of attestation from the member affirming 800 hours of active critical care patient management Current Resume Current Nursing Job Description 2 References Nursing License(s) BLS certificate ACLS certificate Additional certifications (if applicable - desired only) Readiness Skills Verification checklist VERSION 5: 23 JUNE 2015 Page 22 of 31 CCATT ADVANCED COURSE INFORMATION PACKET SAMPLE CCATT RESPIRATORY THERAPIST SELECTION REVIEW PACKAGE Cover Letter Statement of attestation from the member affirming 800 hours of active critical care patient management Documentation of award of 5 skill-level or higher Current Resume Phase II Training certificate (CRT eligibility) CRT certificate (if applicable) Respiratory License BLS certificate ACLS certificate Readiness Skills Verification checklist VERSION 5: 23 JUNE 2015 Page 23 of 31 CCATT ADVANCED COURSE INFORMATION PACKET DEPARTMENT OF THE AIR FORCE ENTER YOUR RESPECTIVE LETTERHEAD HERE 24 Jun 2015 MEMORANDUM FOR FROM: SUBJECT: Request for Publication of Non-InterferenceAeronautical Orders 1. The Critical Care Air Transport Team (CCATT) member listed below will be attending the CCATT Advanced Course. The member will participate in a required training flight on AF aircraft during the course. Member is current in all requirements for operational support flier (OSF) status. IAW AFI 11-401, I request your office publish non-interference aeronautical orders (AO) for the following CCATT member: a. Name: b. Rank: c. SSAN: d. Duty Title: e. Duty AFSC: f. Date Of Birth: g. Date Of Separation: h. Primary Aircraft Type: N/A (All AE Support) i. Effective date of Aeronautical Orders (start date of course): j. Duration of AO’s (duration of course): k. Date of AF Form 1042: ___________, expires ____________. (Copy of AF Form 1042 required) l. Date of AF Form 702: ____________, expires ____________. (Original AF Form 702 required) m. Member completed the CCATT Initial Course, ____________. (Copy of certificate required) 2. POC for this request is ________________________________, Contact # _______________. UNIT COMMANDERS SIGNATURE BLOCK 4 Attachments: 1. AF Form 1042 2. AF Form 702 3. CCATT Initial Course certificate VERSION 5: 23 JUNE 2015 Page 24 of 31 ATTACHMENT 4: UC MEDICAL CAMPUS MAP CCATT ADVANCED COURSE INFORMATION PACKET U N I V E R S I T Y O F C I N C I N N AT I MEDICAL CAMPUS MAP 2010-2011 University Buildings P Parking Garages/Lots Shuttle Stops Bicycle Racks Wireless Locations ATM ATM/VTS Help Phones Wall Mounted Help Phones Libraries Dining Shopping Fitness Center N Cincinnati Zoo and Botanical Gardens ERKENBRECHER AVE. P CCHMC Location B VINE STREET BURNET AVENUE CCHMC North Parking Erkenbrecher Annex CCHMC Location A Cincinnati Children's Hospital Medical Center Louis Avenue Euclid Avenue nd Logan Hall UH Outpatient ATM ATM Shriners Way UH Pavilion A UH Lab UH Critical Care UH Pavilion B University ATM Hospital (UH) ATM French East Building UH Old Operating P Shriners Hospital for Children UH OR/OB Shriners Garage ATM UH Emergency Goodman Drive gate P rriott Kingsenter M a re n c e C ATM C o n fe Goodman Street P ATM Hoxworth Center Goodman Street Garage Cincinnati Dept of Health MARTIN LUTHER KING DRIVE UC Uptown West Campus VERSION 5: 23 JUNE 2015 Stetson Square One Stetson Square P Page 25 of 31 BURNET AVENUE Piedmont Avenue Highland Ave UNIVERSITY COMMONS Barrett Center Bellevue Ave Vontz Center er P ro c t l Hal MSB Service P UH Mont Reid Pavilion Hall Hamilton County Coroner MSB Receiving Albert Sabin Way UH Sabin Way Garage UH Operating East Campus Utility Plant P CCHMC South Parking MRI Cardiovascular Research Center Surgical Research Center EDEN AVENUE TREET rsity Unive Medical Sciences Building (MSB) P UC Physicians Medical Arts Building VINE S P LEVINE PARK CONSTRUCTION CARE/Crawley Building Eden Avenue Garage Lot 11 Levine Drive VAMC gate K ings ge G ara KRESGE CIRCLE ATM VAMC VAMC CCHMC Daycare CCHMC Location F Albert Sabin Way EDEN QUAD Pedestrian Access to MSB on 5th level GOODMAN GATEWAY e Radiation Safety VAMC VAMC CCHMC Location S Wherry Hall P nu Ave Veterans Affairs Medical Center Holmes Hospital Health Professions Building Kettering Lab Complex CCHMC Parking CCHMC Location D Ella P ATM CCHMC Location C CCHMC Location R Shields Street P CCATT ADVANCED COURSE INFORMATION PACKET ATTACHMENT 5: CARDIOPULMONARY COMPETENCY PROFICIENCY ASSESSMENT DEPARTMENT OF THE AIR FORCE HQ 711TH HUMAN PERFORMANCE WING (AFMC) WRIGHT-PATTERSON AFB OHIO 17 June 2013 MEMORANDUM FOR: CARDIOPULMONARY 4H0 AFCFM MAJCOM/4H0 FM MTF/4H0 FM FROM: 711 HPW/USAFSAM/ETS/AFEMSI/CCATT Advanced, C-STARS 234 Goodman Street Cincinnati, OH 45219 SUBJECT: CCATT Advanced Course, C-STARS, Cincinnati References: (a) Career Field Education & Training Plan (b) FFCCT Allowance Standard, Nov 2012 (c) Eagan, D. Egan’s Fundamentals of Respiratory Care, current ed. ISBN: 978-0-3230-1813-5 (d) Hess, D., et al. Respiratory Care, Principles and Practice, 2nd ed. ISBN: 978-0-7637-6003-8 (e) Dubin, D. Rapid Interpretation of EKGs, 6th ed. ISBN: 978-0-9129-1206-6 (f) Shapiro, B. Clinical Application of Blood Gases, current ed. ISBN: 978-0-8016-7839-4 (g) AFTTP 3-42.51, Critical Care Air Transport Teams (CCATT), Sept 2006 (h) Cardiopulmonary Readiness Skills Verification checklist, 23 May 11 https://kx.afms.mil/kxweb/dotmil/kjFolderSearch.do?folder=Enlisted&par entFolder=RSVP+Checklists&queryText=RSVPEnlisted&functionalArea =RSVP (i) Clinical Practice Guidelines, Army Institute of Surgical Research www.usaisr.amedd.army.mil/cpgs.html (j) CCATT Home Page: http://ccatt.info/ 1. The purpose of this memorandum is to help cardiopulmonary technicians hone their knowledge and skills prior to attending C-STARS, Cincinnati. Though this is not an allinclusive list, everything on this list is evaluated by C-STARS cadre with either an UNSAT, NEEDS IMPROVEMENT or SAT at the end of the course to determine validation status. This is a very demanding course…those who arrive familiar with the allowance standard, patient movement items and experienced in respiratory care [in a critical care setting] are positioned for success. It is impossible to train a cardiopulmonary technician to be a proficient respiratory therapist within two-weeks. However, below is a list of a few items 4Hs are expected to be independently competent in: VERSION 5: 23 JUNE 2015 Page 26 of 31 CCATT ADVANCED COURSE INFORMATION PACKET 2. Cardiopulmonary Competency Proficiency Assessment: a. Patient Assessment: - Obtain/evaluate: B/P, MAP, T, HR, RR, SpO2, EtCO2 - Identify O2 requirement & select appropriate delivery device - Identify need for suctioning - Arterial Blood Gas: Identify need for, interpret & apply results: pH, PCO2, PO2, HCO3-, BE, Hgb, Hct - Hemodynamic Monitoring: ID need for & basic understanding of hemodynamics (e.g. CVP, PCWP, B/P, MAP, etc) - iSTAT 7s & 8s Labs: Identify need for, interpret & apply results - Lung compliance: Obtain & evaluate Static/dynamic compliance and restrictive/obstructive trends - Identify and troubleshoot increased airway resistance - Chest Radiograph: Evaluate/interpret basic findings - Auscultate breath sounds and evaluate pulmonary status - Identify the need for further pulmonary related testing i.e.: Bronchoscopy, PFT, Chest Radiograph, etc. - Complete review of pt history: interview, chart review & report b. Support During Emergency Procedures: - Identify, interpret and respond to warning/lethal arrhythmias Perform multiple roles during CPR & emergency procedures Advanced Cardiac Life Support (authorized to utilize algorithm reference) Identify compromised airway, secure & manage Proper selection and utilization of airway adjuncts Intubation: Set-up, insertion, secure & exchange via Cook catheter Evaluate placement of ETT Mechanical Ventilation: Indications/Complications and liberation from Extubation: Set-up, extubation, secure airway & evaluate Start, manage and remove peripheral IV access Assess need for and insert IO (Cadaver Lab) Bronchoscopy: set-up & assist c. Pharmacology: - Articulate: Indications, contraindications, delivery methods, dosage, calculation, adverse reactions & generic/trade name. Reference Allowance Standard. d. Oxygen Delivery: - VERSION 5: 23 JUNE 2015 Nasal cannula Mask: Simple, Venturi & Non-Rebreather Manipulation to maintain SpO2/SaO2 & EtCO2 Articulate indications, contraindications & hazards of Oxygen Calculation of Oxygen requirements for transport [gas & liquid] Page 27 of 31 CCATT ADVANCED COURSE INFORMATION PACKET e. Patient Movement Items: - Physiologic monitoring unit (Propaq) Zoll & Phillips Defibrillator SMEED iSTAT Blood gas analyzer Flow meter & pressure regulator (PISS & DISS) Wrights Respirometer Codman Ventric & Interface Control Unit Suction Unit (Impact 326) IV Triple Channel Pump (IVAC) f. Mechanical Ventilation: - Impact 754 and 731: set-up, initiate, manage & troubleshoot. LTV 1000: set-up, initiate, manage & troubleshoot. Manipulate ventilator based on compliance and/or ABG interpretation Modes of Ventilation PEEP Therapy Ventilator Induced Lung Injury ARDSnet Protocol/Lung Protective Strategy 3. For any questions, comments or concerns, please feel free to contact me via james.woods@uchealth.com or via 513.584.0331. //jmw, 17 June 2013// JAMES M. WOODS, MSgt, USAF Superintendent, C-STARS Cincinnati VERSION 5: 23 JUNE 2015 Page 28 of 31 CCATT ADVANCED COURSE INFORMATION PACKET ATTACHMENT 6: FLIGHT/JUMP TDY WORKSHEET Name: SSAN (Last 4): TDY Period Start Date: End Date: Physical (Note 1) Accomplished: Expires: Physiological Accomplished: Expires: Training (Note 2) Egress (Note 3) Accomplished: Expires: AOs Current ASC: Termination Date: Physical Avail Date: Code: Notes: 1. If member‘s physical will expire during TDY, member must contact the FME ASAP to schedule and accomplish prior to departing TDY. 2. If member‘s physiological training will expire during TDY period, member must attend training prior to TDY, unless available at TDY location and scheduled prior to class start date. 3. If not current on Emergency Egress for aircraft member will be flying on TDY, direct member to complete prior to departure (if possible) or prior to first flight at training base. I understand I am not authorized to depart TDY for training without valid AOs, current physical, current physiological training (none of which will expire during TDY period), or in DNIF status. If I do, I may be returned to home station prior to completion of training. Member‘s Signature: Date: Note: I validate the above individual is physically and physiologically qualified for the complete TDY period, IAW documentation in the members FRF and ARMS. I provided member with a current Individual Data Summary, Individual Training Summary, and Flying History Report. SARM/HARM Representative Signature: VERSION 5: 23 JUNE 2015 Date: Page 29 of 31 CCATT ADVANCED COURSE INFORMATION PACKET ATTACHMENT 7: WELCOME LETTER DEPARTMENT OF THE AIR FORCE USAF SCHOOL OF AEROSPACE MEDICINE (AFMC) C-STARS CINCINNATI 8 May 2012 MEMORANDUM FOR CCATT ADVANCED COURSE STUDENTS FROM: Director, C-STARS Cincinnati SUBJECT: Center for the Sustainment of Trauma and Readiness Skills (C-STARS) 1. Welcome to C-STARS Cincinnati. You have been selected for one of the most critical jobs in the Air Force today. Your command selected you based on your experience and skills. We look forward to seeing you demonstrate those attributes here over the next two weeks. 2. This course is likely to be unique in your military and medical career. I am well aware that each of you has gone through extensive training in the past. Some of you spent years completing your education and some of you are very senior, experienced providers. During the next two weeks you will have ample opportunity to demonstrate all that you have learned along the way. This course will be the first time some of you have been exposed to simulation training. It is intense, not only because of the noise, lowlights and difficult scenarios, but also because you will go into these simulations knowing that you are being evaluated and tested. We have all gone through this and we all know how much stress being evaluated can add to each scenario. Still, you should understand right now that the stress we create in our simulation room will never come close to the stress level you should feel when you are four hours either way from a hospital and your patient is crashing. It has happened to nearly every CCAT team that has deployed, and the way they respond makes all the difference in the world to that soldier and the family waiting for him. 3. This is not a weeding out course as some have referred to it. There is no hidden agenda or quota of failures and passes. Historically the failure rate has been around 13%, but we have had many classes with 100% validation. I, and the entire cadre, want to see you succeed. However, I will not allow the standards to slip for anyone, regardless of rank or years of experience. I have spent too many years treating these soldiers and living with them down-range to accept any chance that the team in the plane with them at the critical moment is even possibly not up to the task. We will do everything in our power to teach you the “tricks of the trade.” We will refresh skill sets that you may not have used in awhile. I recognize that many of you may not have seen patients like this in daily practice. That does not mean you cannot do the job well. Success comes from preparation. That means you have to come prepared for every mission, including this class. You are expected to arrive here familiar with the Clinical Practice Guidelines and all of your equipment. We will review all of it here, but if you arrive without reviewing these critical starting points, you are setting yourself up for a difficult task. We only have two weeks to cover a great deal of material with you. If you are not prepared you will feel overwhelmed by the amount of information you are absorbing. Please, use your resources and show up as prepared for your time here as you would for any mission down-range. To do otherwise speaks volumes about your character and commitment to the patients you will treat. 4. During your time in Cincinnati you are likely to feel uncomfortable. I am sorry, but there is no getting around that fact. Very few of you will have ever been critiqued with such scrutiny as you will find here. That is an inherently uncomfortable experience. This is a validation platform. You will be instructed throughout the two weeks, but make no mistake, the primary mission of this platform is validation. What VERSION 5: 23 JUNE 2015 Page 30 of 31 CCATT ADVANCED COURSE INFORMATION PACKET 5. I will promise you is a fair and professional process. Although critique is never comfortable, the cadre will provide you with constructive criticism after every simulation and throughout the course. If at any point you feel it is being done otherwise then I expect two things from you. First, pause and reflect on whether it was inappropriate or is your pride just stinging. Second, if you still feel there was any issue, bring it to me immediately. I expect a great deal of every student that comes through this course, but I expect even more from the cadre. Pass or fail, I want you to leave this course feeling better for the experience. //Signed// MICHAEL C. PETRO, MD, FACS Lt Col, USAF, MC Director, C-STARS Cincinnati VERSION 5: 23 JUNE 2015 Page 31 of 31
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