When a patient is transferred from a community hospital to an acute care setting, the nurse is expected to take the lead.
Critical care transport nurses must be capable of rapid patient assessment and have a working knowledge of various treatment modalities.
In New Jersey, law mandates patients must be transferred on a critical care transport ambulance if they need more assistance than can be provided on a basic life support ambulance. BLS ambulances are staffed by two emergency medical technicians and are capable of transporting most patients who require oxygen and vital-sign monitoring. But more intensive patients require transport on a critical care transport ambulance with an RN on board. CCT ambulances are equipped with a cardiac monitor, IV pumps, and ventilator as well as intubation, airway and medication administration equipment.
“Often when working in a hospital there are other nurses, physicians and respiratory therapists available to assist if your patient becomes unstable,” said transport nurse Heidi Spaanstra, RN, EMT-B, a critical care nurse with LifeStar Response of New Jersey. “When it’s just an EMT and yourself in the back of an ambulance, you must be adequately trained and prepared for almost any situation.”
The inter-facility critical care transport team includes one or two EMTs and a New Jersey-licensed RN who has maintained ACLS and PALS certification and critical care experience, according to the State Office of Emergency Medical Services.
“When I get on the ambulance at the beginning of my shift, I’m never quite sure where my job will take me throughout the day,” Spaanstra said. “The possibility exists to transport patients who are ventilator-dependent, require neurological monitoring, must be observed using a cardiac monitor or have running IV medications/fluids.”