The Maryland ExpressCare (MEC) Senior Critical Care Transport Specialist (SRCCTS) must be able to function as a member of a highly effective, high-acuity, high-volume critical care transport team. Team members in this role are expected to work collaboratively and respond quickly and appropriately in fast-paced clinical situations requiring immediate action both in and out of the hospital environment.

The SRCCTS has an expanded paramedic scope of practice and provides high-acuity critical care and emergency ground/surface transportation for the following patient populations; Stroke, STEMI, trauma, medical, surgical, cardiac, neurologic, high risk obstetrics, neonatal, and pediatric. The SRCCTS works with physician medical directors, critical care transport nurse specialists, and providers to provide high acuity medical therapies and interventions. This role functions under the authority of (1) MEC clinical guidelines and (2) Maryland Institute for Emergency Medical Services Systems (MIEMSS) protocols when appropriate. The position works closely with healthcare providers at sending and receiving facilities to articulate a comprehensive transport plan. The scope of practice includes patients from all age groups.

In addition to transport duties, the SRCCTS also leads operational teams working on various organizational initiatives.

Principal Responsibilities and Duties

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
Clinical Practice/Care Delivery

1. Independently provides, directs and coordinates clinical care within the critical care transport environment. Is accountable for the processes and outcomes of care delivered to patients.
   • Conducts comprehensive patient assessment, integrating multiple data sources, which forms the basis for identification of patient/family needs and problems.
   • Observes patients in a systematic way for both overt and covert clinical signs and symptoms.
   • Assess patient's needs prior to and during transport, and implements a patient-specific plan of care to address noted needs.
   • Facilitates effective transportation of patients between referring and receiving institutions.
   • Works effectively with the University of Maryland Access Center (UMAC) and multidisciplinary teams at both sending and receiving facilities to plan patient care.
   • Under orders from the base station attending physician or established MEC medical guidelines, initiates immediate life support therapies including but not limited to parenteral administration of approved medications; intravenous/intraosseous therapies; EKG monitoring; arrhythmia interpretation; CPR; defibrillation; external cardiac pacing; airway management; endotracheal intubation; cricothyrotomy (needle or surgical); vent22ilator operation; needle chest decompression; high acuity transports with advanced life-sustaining equipment, including but not limited to management of patients with Extracorporeal Membrane Oxygenation (ECMO) and Intra-Aortic Balloon Pumps (IABP); altered neurological status; including cervical spine immobilization; application of splints and devices needed for transport.
   • Responds to all internal and external crisis interventions, e.g.; Go Team requests, Novel Pathogens, outpatient assistance.
   • Consistently and accurately provides comprehensive reports to the receiving medical team on patient's status and interventions provided during transport.
   • Utilizes available resources within and outside the hospital for the purpose of providing comprehensive care to patients and families.
   • Evaluates and revises individualized plans of care to appropriately reflect current and changing status of the patient and/or family.
   • Continuously assesses, monitors, intervenes, and stabilizes critically ill patients during transport and offers additional or alternate plans of care as needed.
   • Uses chart review sessions as a forum for patient care evaluation and learning.

Professional Development

1. Responsible for maintaining competencies required for the patient care setting; focus on advancing own professional development
2. Serves as an expert preceptor, coach, and mentor to new MEC employees
3. Serves as an expert resource in the delivery of clinical care to patients.
4. Independently attends mandatory training, in-services, and education classes specific to MEC

Service Quality and Safety

1. Leads unit-based initiatives for process improvement plans, including data collection
2. Recognizes potential/actual patient/family issues and addresses noted concerns

Operations

1. Supports charge RN
2. Models' teamwork and coaches' others (cooperates with peers, flexible with dispatched calls)
3. Leads unit level decision making via governance model
4. Holds leadership role in unit-based committee(s)
5. Leads and/or participates in various educational and quality improvement initiatives
6. Collaborates with other specialty receiving units or interdisciplinary groups within UMMS. Represents MEC at specialty or interdisciplinary meetings to discuss relevant transport concerns.
7. Contributes to performance management processes, and is responsible for performance reviews as delegated by the MEC Nurse Manager
8. Participates and supports the American Association of Critical Care Nurses guidelines for Healthy Work Environment (communication, collaboration, effective decision making, recognition, leadership, staffing)
9. Demonstrates knowledge and skills necessary to provide care appropriate to the patient population(s) served. Demonstrates knowledge of the principles of growth and development over the life span and possesses the ability to assess data reflective of the patient's requirements relative to his or her population-specific and age specific needs. Provides the care needed as described in organizational policies and procedures
10. Leads Healthy Work Environment (communication, collaboration, effective decision making, recognition, leadership, staffing) initiatives.