Critical Care Transport
ABOUT CRITICAL CARE TRANSPORTCritical Care Transport is a hospital-based, inter-facility transport program for patients in the United States and worldwide who require transport from one medical facility to another. Launched in 1983 in Birmingham, Ala., Critical Care Transport has served more than 48,000 patients to date. Jet aircraft-based intensive care units provide advanced support during long-distance transports. For local transports, Critical Care Transport utilizes three mobile intensive care unit (ICU) vehicles that maintain sophisticated, uninterrupted ICU care. Patients do not have to be going to or from UAB Hospital.
Critical Care Transport is available 24 hours a day, 365 days a year. Complete arrangements for bedside-to-bedside transport – including ground transportation before and after air trips – are made by the Critical Care Transport coordinator. All coordinators are registered nurses or registered respiratory therapists.
One twin-engine jet is available at all times for immediate dispatch with the most appropriate transport team based on the patient's requirements. Other aircraft are available for long-distance or international transports. Three large, ground-based mobile ICU vehicles are used for local transports within approximately 125 miles of Birmingham.
Each adult medical transport team includes an ICU registered nurse (RN) and a registered respiratory therapist, and physicians are available 24/7. Each team member is specially trained in aeromedical physiology. For neonatal patients, a neonatal nurse practitioner or neonatal ICU RN and respiratory therapist will be part of the transport care team.
Critical Care Transport’s onboard medical capabilities include:
- Ventilator management
- End-tidal CO2 monitoring
- High-flow oxygen
- Nitric oxide (adult and neonatal)
- Neonatal high-frequency ventilation
- Laboratory analysis
- Intra-aortic balloon pump
- Ventricular assist devices
- Extracorporeal membrane oxygenation (ECMO) management and cannulation
- Intra-cranial pressure monitoring
- Transvenous pacing
- Hypothermia management
- Critical Care Transport History
- Critical Care Transport Fun Facts
- Did its first transport in March 23, 1983 of quadruplets from UAB Hospital to Brookwood Medical Center.
- Has transported to 46 states and 38 countries
- Had the first civilian aircraft in the country with a liquid oxygen system; the oxygen canisters had serial numbers 1 and2.
- Has appeared on The Learning Channel, the National Geographic Channel, Discovery Channel, CNN, MSNBC and the film CCT team members starred in, “Johnny Flinton”, won an Oscar in 2003 for Best Short Films.
- Provided the medical team for President Bush's visit to Birmingham in 2001.
- Has performed up to 77 defibrillations on one transport. And the patient survived!
- Supplied one of the first 10 items writers for the Certified Flight Registered Nurse exam and served on the Exam Construction and Review Committee
- Has two brands of equipment that are still in use that have been used since the beginning of the program: the MVP-10 ventilator and Airborne isolette.
- Evacuated 21 patients during Hurricanes Katrina & Rita and provided staff, supplies, equipment and ambulances for NDMS (National Disaster Management System) twice in 2005
- Transported 8 babies simultaneously in the jet out of New Orleans during Hurricane Gustav in 2008
- Were the only civilian aircraft allowed back in the air on 9/11 returning a patient from Monroe, LA to UAB.
- Has the first Cessna Citation Bravo jet in the world to have a clam-shell type door installed
- Was the first U.S. aircraft to fly a new route over Cuban airspace to evacuate an earthquake victim following the earthquake in Haiti January 2010. This saved 30 critical minutes flight time, and the new medevac flight path was followed by many air ambulances afterward.
- “Ground transportation” on one international trip was a gondola in Venice.
- Supplied the ground content for ASTNA’s Transport Safety Position Paper in 2006 making it the first transport professional association to have all modes addressed in a safety position statement.
- Co-edited, authored and reviewed several chapters in ASTNA’s (Air and Surface Transport Nurses Association) Standards for Critical Care & Specialty Care Ground Transport, 2nd Edition” published in 2010. CCT also did the artwork for the book cover.
- Longest working full-time team member: Valorie Tucker, NNP, worked from 1999 – 2010, transported 1842 patients and traveled ~ 680,000 miles
- Most transports in one day – 23; Transport Coordinator Sheryl Pettis
- Most intra-aortic balloon pump transports in one day: 3 on multiple dates
- First nurse to transport 2,000 patients: John Doriety, RN, CCRN on 1-28-2016
- Research and Publications
- Frequently Asked Questions
- Critical Care Transport's Jet Aircraft
- International Transports
Critical Care Transport History
Critical Care Transport Fun Facts
Critical Care Transport…
Standing CCT Records:
Research and Publications
Demmons, L., “Infectious and Communicable Diseases”; Clark, D., Treadwell, D., et al (2017), ASTNA Critical Care Transport Core Curriculum, Air and Surface Transport Nurses Association, Aurora, CO, p. 423-434.
Demmons, L., James, S., (2010) ASTNA Standards for Critical Care and Specialty Ground Transport, 2nd Edition, Air and Surface Transport Nurses Association, Centennial, CO, Cottrell Printing Company.
Demmons, L., "Twenty-five Years Later: Critical Care Transport", Air Medical Journal, Nov - Dec 2008, Vol. 27, No. 6, p. 276-280.
Air and Surface Transport Nurses Association: Demmons, L, Stevens, L, High, K, Lin, J., "Transport Nurse Safety in the Transport Environment, Position Paper", Sept 2006.
Demmons, L., "Chasing Ambulance Safety", Air Medical Journal, May-June, 2005.
Gruszecki, A., Kahler, D., Smith, D., Vines, J., Lancaster, L., et al, "Utilization, Reliability and Clinical Impact of Point-of-care Testing during Critical Care Transport: Six Years of Experience", Clinical Chemistry, Vol. 49, No. 6, 2003.
Commission on Accreditation of Medical Transport Systems Best Practices, Volume II, 2001; Volume III, 2004; most cited program in Volume IV, 2007; Volume V, 2012; and Volume VI, 2017
Randolph, V., Kahler, D., Howard, C., Hortin, G., "Laboratories on the Move: Blood Gas Analysis", Laboratory Medicine, Vol. 31, No. 1, 2000.
Brunson M., Lancaster L., "Transport of Critically Ill Patients: How to Avoid Pitfalls", Clinical Pulmonary Review, Vol. 6, No. 4, July 1999.
Demmons, L., Cook,E., "Anxiety in Adult Fixed-Wing Air Transport Patients", Air Medical Journal, July - September 1997.
Frequently Asked Questions
Q: Will insurance companies pay for the services of Critical Care Transport?
A: Most major commercial insurance companies will cover 50 to 80 percent if "medical necessity" terms are met. However, persons should check with their insurance company to discuss individual coverage.
Q: What about Medicare Coverage?
A: For medicare to cover ground/air transport, a patient must be in a condition that would justify the need for transport. "Medical necessity" must be established. In addition, for maximum coverage, Medicare requires that the patient be transported to the "nearest appropriate facility."
Q: How does CCT determine to fly or drive a patient for transport?
A: Generally, patients within 100 to 150 miles radius of Birmingham will be driven from one facility to another. The patients outside of the 125 mile radius will usually be flown from the referring facility to the receiving facility.
Q: Will Critical Care Transport move a patient to a hospital other that UAB?
A: Yes. However, for patients to be transported to a facility other than UAB, payment must be secured prior to the transport. We can bill the insurance of most patients who have Medicare or Blue Cross. Certified check, VISA, Master Card, Discover, or American Express can be used. Persons should ask the transport coordinator if their hospital or company has an agreement with CCT, as many do. If this agreement exists, then the requirements for pre-payment will be waived. Some insurance companies, with prior arrangements, will allow CCT to bill the insurance company directly.
Q. Do you have a service available if you are traveling in the U.S. or abroad, become sick or injured and want to get back home?
A. Yes. Critical Care Transport works with AirMed Intl. to provide these repatriation services for an annual fee. You may call (205) 443-4840 or go to www.AirMed.com/UAB for more information and to obtain your membership instantly.
We understand that you may have additional questions. Please feel free to contact the Critical Care Transport Coordinator at 1-800-822-6478 to have these questions answered.
Critical Care Transport's Jet Aircraft
This Cessna Citation Bravo twin-engine jet flies at 480 miles per hour and has an un-refueled cruising range of 1700 miles. It can accommodate two adult or neonatal patients and has seating for up to five team members. The aircraft features custom design with installed medical air, dual suction system and dual inverter; liquid oxygen, air, and inverter; sectional/removable bench seat for intra-aortic balloon pump transports; installed Air Cell telephone; interior compartment storage for medical equipment and supplies; cabin area Flight Status Panel showing air speed, distance to next stop, outside altimeter and interior cabin altimeter. It is the first Bravo in the world with a cargo door, 36 inches wide, to facilitate loading for patients on stretchers. All pilots undergo annual simuflite training and have achieved their ATP (Air Transport Pilot).
The aircraft is operated by AirMed International, Air Carrier Certificate # MDGA382G.
Worldwide transport service is available through Critical Care Transport. International transports are equipped and staffed as domestic transports
Some advance notice is required for international transports due to overnight requirements. Due to the length of some of the transports, an overnight stay may be required. All arrangements for the overnight stay, as well as all other components of the trip, will be arranged by the transport service.
Because international transports are usually not covered by insurance, financial arrangements must be secured prior to US departure.