IBSC FP-C Candidate Handbook PDF

Candidate Handbook The FP-C examination and certification program is accredited by the National Commission for Certifying Agencies (NCCA) June 2023  Certified Flight Paramedic Candidate Handbook May...

Candidate Handbook The FP-C examination and certification program is accredited by the National Commission for Certifying Agencies (NCCA) June 2023  Certified Flight Paramedic Candidate Handbook May 2019 Table of Content HOW TO CONTACT THE IBSC, PROMETRIC & TESTRAC......................................................................................... 3 POPULATION BEING CERTIFIED................................................................................................................................ 4 INTRODUCTION............................................................................................................................................................ 5 ELIGIBILITY................................................................................................................................................................... 5 TESTING AGENCY......................................................................................................................................................... 5 STATEMENT OF NON-DISCRIMINATION.................................................................................................................. 5 APPLYING FOR AN EXAMINATION............................................................................................................................ 6 SCHEDULING AN EXAMINATION............................................................................................................................... 6 EXAMINATION LOCATIONS.......................................................................................................................................... 6 CHANGED, MISSED, OR CANCELLED APPOINTMENTS.......................................................................................... 6 PREPARING FOR THE EXAMINATION....................................................................................................................... 6 FP-C EXAM CONTENT.................................................................................................................................................. 7 MAINTAINING YOUR CERTIFICATION...................................................................................................................... 7 AUDITS........................................................................................................................................................................... 7 DISCIPLINARY POLICIES............................................................................................................................................. 7 FP-C CONTENT OUTLINE (BLUEPRINT).................................................................................................................... 7 ON THE DAY OF YOUR EXAMINATION.................................................................................................................... 14 SECURITY..................................................................................................................................................................... 14 EXAMINATION RESTRICTIONS................................................................................................................................ 15 MISCONDUCT.............................................................................................................................................................. 15 FOLLOWING THE EXAMINATION............................................................................................................................ 16 SCORE REPORTING.................................................................................................................................................... 16 WHEN YOU PASS THE EXAMINATION.....................................................................................................................17 IF YOU DO NOT PASS THE EXAMINATION...............................................................................................................17 SCORES CANCELLED BY THE IBSC OR PROMETRIC...............................................................................................17 APPROVED ABBREVIATION LIST............................................................................................................................. 18 Updated June 2023 – Controlled Document Page 2  Certified Flight Paramedic Candidate Handbook HOW TO CONTACT THE IBSC International Board of Specialty Certification (IBSC®) 5144 Belmore Manor Court Suwanee, GA 30024 USA Phone: +1 (770) 978-4400 E-mail: [email protected] Web: www.IBSCertifications.org HOW TO CONTACT PROMETRIC Prometric 1501 South Clinton Street Baltimore, MD 21224 USA Phone: +1 (800) 462-8669 Web: www.Prometric.com HOW TO CONTACT TESTRAC TesTrac 1409 Summit Oaks Drive Burnsville, MN 55337 Phone: +1 (952)-953-6292 Web: www.testrac.com Updated June 2023 – Controlled Document Page 3  Certified Flight Paramedic Candidate Handbook POPULATION BEING CERTIFIED The Certified Flight Paramedic (FP-C) exam candidate is a paramedic professional seeking employment with or who is currently associated with an air medical transport service. The candidate must possess an advanced level knowledge of the various transport environments, not the sole requirements or specifications for any one individual transport program or patient population, i.e.: adult, pediatrics, neonatal, maternal, etc. Candidates must have an understanding of advanced level patient care pathophysiology, while maintaining a significant knowledge of current standards established for Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Neonatal Advanced Life Support (NALS), International Trauma Life Support (ITLS), and industry accreditation standards. This certification examination is beyond the scope of the average, entry-level field paramedic and is not intended to evaluate entry-level knowledge; but rather to measure the experienced paramedic's skills and knowledge of the patient requiring critical care intervention during the various aspects of patient transport, i.e.: ground ambulance, helicopter, aircraft, marine/boats, etc. The target audience for the Certified Flight Paramedic (FP-C) certification is any licensed or certified paramedic functioning in a specialty and or air medical critical care area of clinical practice. The broader audience includes the following: United States government United States military as well as foreign militaries Federal, state, and local Emergency Medical Services (EMS) providers Private and government operated Emergency Medical Services (EMS) agencies Helicopter and fixed wing medical transport programs Marine transport, i.e.: U.S. Navy, maritime vessels, etc. Hospitals and various acute care medical facilities Education institutions such as local and state colleges or technical centers that provide Emergency Medical Services (EMS) training Municipal fire protection departments Various local, state, and federal police or law enforcement agencies Other areas around the globe that already or may require specialty certification, i.e.: State Department operations, Department of Defense (DoD), etc. For additional questions related to qualifying for a certification examination, please contact the IBSC at +1 (770) 978-4400 or via [email protected]. Updated June 2023 – Controlled Document Page 4  Certified Flight Paramedic Candidate Handbook INTRODUCTION PRACTICE TESTS The International Board of Specialty Certification The IBSC has partnered with TesTrac to provide on-line (IBSC) is responsible for the construction, practice tests. Practice tests provide the candidate with administration, and maintenance of the Certified Flight examples of item format, style, and environment. Practice Paramedic (FP-C) examination. tests are optional and not a pre-requisite to register for the FP-C oard certification exam. Practice tests may be The IBSC does not believe paramedics should work in purchased at the air medical transport environment without being https://www.ibscertifications.org/exam/exam- certified. The legal risk to the employer and the medical preparation director is exponentially increased without validation of clinical competency. The FP-C certification targets TESTING AGENCY competency at the mastery level of paramedic practice The IBSC has partnered with Prometric – a leading coupled with entry-level competency over the provider of technology-enabled testing and assessment knowledge, skills and abilities contained within the solutions to many of the world’s most recognized Flight Paramedic specialty. licensing and certification organizations, academic institutions, and government agencies. Annually ELIGIBILITY supporting more than 7 million test takers in 160 To obtain certification, the candidate must meet each countries around the world. Prometric assists with the of the following: development, administration, scoring and analysis of Hold an unrestricted license or certificate to the Certified Flight Paramedic (FP-C) examinations. All practice as a paramedic CBT and RPT examination delivery are provided by the Complete an approved examination application Prometric testing center network with RPT being Submit paramedic license or certification for offered by the Prometric ProProctor platform. All MED verification and approval delivery is coordinated directly through the IBSC office. The examination is available in computer-based STATEMENT OF NON-DISCRIMINATION testing (CBT), mobile exam delivery (MED), and IBSC and Prometric do not discriminate among remote proctor testing (RPT) formats. candidates on the basis of age, gender, race, color, religion, national origin, disability, or marital status. To maintain certification, the certificant must meet all eligibility requirements, as well as demonstrate REQUEST FOR ACCOMMODATION continued competency by meeting all recertification To be considered for an accommodation under the requirements. These requirements can be found on the ADA, an individual must present adequate IBSC web site at documentation demonstrating that his/her http://www.ibscertifications.org/exam/exam- condition substantially limits one or more major life requirements activities. Only individuals with disabilities who, with or without reasonable accommodations, meet The board is not affiliated with – nor part of – any trade the eligibility requirements for certification at the level of the requested examination are eligible for organization and is not involved with any review accommodations. courses offered to the public. If you have questions concerning the board or the administration of the For more information related to accommodations, examinations, please contact the IBSC at please contact the IBSC at +1 (770) 978-4400. [email protected] or by calling the IBSC office at +1 (770) Additional information can also be found at 978-4400 – 1000-1600 Eastern Time Monday – http://www.ibscertifications.org/resource/pdf/AD A.pdf Friday. Updated June 2023 – Controlled Document Page 5  Certified Flight Paramedic Candidate Handbook APPLYING FOR AN EXAMINATION Twenty-nine (29) to five (5) days prior to your Register for the FP-C examination via the IBSC website appointment date – a $100 rescheduling or at www.IBSCertifications.org or by contacting the cancellation fee applies IBSC office at +1 (770) 978-4400. After your completed If four (4) or less days prior to your appointment – you registration and fees have been submitted and must: approved, you will receive an electronic notice First, cancel your appointment on-line with confirming your eligibility to take the examination. A Prometric testing confirmation number will be issued along with Then contact the IBSC at +1 (770) 978-4400 to instructions how to schedule your exam. The period of reschedule – you must cancel with Prometric testing eligibility is one year. prior to contacting the IBSC A $100 rescheduling or cancellation fee applies SCHEDULING AN EXAMINATION You will forfeit your examination registration and Check the www.IBSCertifications.org website for all fees paid to take the examination under the scheduled on-site (MED) examinations. Computer- following circumstances. based (CBT) examinations and remote proctor You arrive after the examination start-time for a testing (RPT) can be scheduled at MED or CBT examination appointment. www.Prometric.com/IBSC. Follow the simple step- You are more than 15 minutes late to the exam. by-step instructions to register for your examination. You fail to report for an examination appointment. A new, complete registration and all examination fees EXAMINATION LOCATIONS are required if you chose to reapply for any The IBSC offers our entire family of examinations examination. including FP-C®, CCP-C® , CP-C®, DICO-C, MTSP- C®, TP-C®, TR-C®, and WP-C® exams at To change the type of examination (e.g.: from FP-C to conferences, colleges, and public facilities around CCP-C), or the mode of testing (e.g.: CBT to RPT, RPT the world. to MED, etc.), contact the IBSC Office at +1 (770) 978- 4400 or [email protected] – additional fees will apply. CBT examinations are administered at Prometric Assessment Centers geographically distributed All examination candidates will adhere to the IBSC throughout the world. MED and RPT options are rules and acknowledge the IBSC has a disciplinary based on location, computer accessibility, and process that affords everyone due process. Exam fees internet connectivity. Assessment Center locations are non-refundable. and RPT specifications can be found at http://www.prometric.com/IBSC UNSCHEDULED CANDIDATES (WALK-INS) ARE NOT ADMITTED TO ANY IBSC CHANGED, MISSED, OR CANCELLED EXAMINATION. APPOINTMENTS For on-site (MED) examinations, contact the IBSC PREPARING FOR THE EXAMINATION Office at +1 (770) 978-4400 or [email protected] The first step is to complete the eligibility process. The candidate must complete an approved application – For CBT or RPT examinations, you can change or cancel providing proof of paramedic licensure or certification. your examination appointment date in the Prometric The examination is designed to validate the unique scheduling portal at http://www.prometric.com/IBSC knowledge and skills of the Flight Paramedic. or 800-462-8669. The following rules apply: Experience in the critical care transport environment More than thirty (30) days from your and additional education in this specialty area are highly appointment date – no change fees apply recommended to be being successful on the examination. Updated June 2023 – Controlled Document Page 6  Certified Flight Paramedic Candidate Handbook FP-C EXAM CONTENT renewal, it must have occurred during the four-year The Certified Flight Paramedic (FP-C) Examination period of certification. See guidelines at consists of 135 multiple-choice questions (110 scored and http://www.ibscertifications.org/recert/recert- 25 non-scored pretest questions) and the candidate is requirements provided 2.5 hours to complete the examination. The certification process measures the cognitive knowledge and overall competency of master-level paramedics AUDITS The IBSC reserves the right to investigate recertification functioning in a specialty area of transport medicine (i.e., air medical and or ground critical care). material at any time. You must retain documentation of all continuing education. Failure to submit education when audited will result in denial of eligibility to The questions on the examination are based in sound recertify. paramedicine. The candidate is expected to maintain a significant knowledge of current ACLS, PALS, NRP, and ITLS/PHTLS standards. This examination is not meant DISCIPLINARY POLICIES to test entry-level knowledge, but rather to test the The IBSC has disciplinary procedures, rights of appeals, experienced paramedics’ skills and knowledge of critical and due process within its policies. Individuals applying care transport. for certification or recertification who wish to exercise these rights should review the following Review and As you prepare for the examination, please consider Appeals Process Policy and the Denial, Suspension, or there are a variety of mission profiles throughout the Revocation of Certification Policy located on the spectrum of transport medicine. This examination tests IBSC web site. Requests to appeal must be submitted the candidates’ overall knowledge of the transport within thirty days (30) calendar days of receipt of notice environment, not the specifics of one individual of a determination. program. Just because your program does not complete IABP transports, does not mean you will not have FP-C CONTENT OUTLINE (BLUEPRINT) questions related to these types of transports. Likewise, if your program does not perform SAR, you still need to TOPIC AREAS # items understand this information for the examination. We SAFETY AND TRANSPORT 9 have included a brief outline below of the topics and FLIGHT PHYSIOLOGY 7 skills included in the exam. As you can see, most of AIRWAY, ANESTHESIA, AND 17 these are beyond the scope of the average field ANALGESICS paramedic. Though some outline topics within the MEDICAL EMERGENCIES 14 paramedic’s scope of practice, the exam questions will NEUROLOGICAL 12 be related to critical care and are of a much higher level CARDIAC 14 of difficulty. The detailed content outline follows. TRAUMA/BURN 13 MATERNAL FETAL AND 8 MAINTAINING YOUR CERTIFICATION NEONATAL A minimum of 100 contact hours must be submitted PEDIATRIC 9 with a clear and direct application to the practice of PROFESSIONAL 7 medicine in their area of specialty. Seventy-five of the CONSIDERATIONS contact hours must be in the CLINICAL category. TOTAL SCORED ITEMS 110 Sixteen CLINICAL hours must be from an approved FP-C review class. Twenty-five CE's may be in the NOTE: Each test form includes 25 unscored pretest OTHER category to complete the 100 hours. It is items in addition to the 110 scored items for a total of acceptable to have more than 75 of the contact hours in 135 items in a 2.5-hour test timeframe. the CLINICAL category. For CE to be applicable for Updated June 2023 – Controlled Document Page 7  Certified Flight Paramedic Candidate Handbook FP-C Content Outline (Blueprint) I. Safety and Transport 8% (9 items) 1. Aircraft operations 2. Aerodynamics 3. Aircraft performance 4. Emergency procedures (e.g., fire, de-pressurization, IIMC) 5. Landing zone operations 6. Obstacle avoidance procedures 7. Survival techniques 8. Weather patterns 9. Refueling operations 10. Personal wellness (e.g., fatigue, fitness for duty) 11. Hazard reporting 12. Communication and radio operations 13. Safety and restraint systems 14. Pre-flight check 15. Passenger briefing 16. Risk assessment 17. Night vision goggle operation (NVGO) 18. GPS and navigation II. Flight Physiology 6% (7 items) 1. Gas laws 2. Hypoxias 3. Stressors of flight 4. Altitude injuries 5. Time of useful consciousness (TUC) 6. Pressurized versus unpressurized aircraft cabins III. Airway, Anesthesia, and Analgesics 15% (17 items 1. Airway assessment 2. Anatomy and physiology 3. Pharmacology 4. Passive oxygenation 5. Failed airway 6. Surgical airway 7. Mechanical ventilation 8. Alternative airway devices 9. Peri-intubation arrest 10. Special airway considerations (e.g., tracheostomy) 11. Tube confirmation and monitoring 12. Airway suctioning 13. Waveform capnography monitoring 14. Non-invasive positive pressure ventilation Updated June 2023 – Controlled Document Page 8  Certified Flight Paramedic Candidate Handbook IV. Medical Emergencies 13% (14 items) 1. Endocrine system 2. Adrenal system 3. Renal system 4. Metabolic 5. Sepsis 6. Infectious disease 7. Toxicology 8. Blood products 9. Gastrointestinal 10. Lab values (e.g., CBC, Coag, BMP, ABG, Cardiac panel) 11. Advanced medical assessments 12. Treatment modalities 13. Invasive line procedures 14. Radiographic interpretation 15. Respiratory system (e.g., Krebs cycle, oxyhemoglobin disassociation curve, intrathoracic pressure) V. Neurological 11% (12 items) 1. Neurological assessment 2. Seizures 3. Altered mental status 4. Cerebral Ischemia (e.g., large vessel occlusion) 5. Neuroprotective strategies (e.g., positioning, hemodynamics, EVD management) 6. Cerebral hemorrhage 7. Traumatic brain injury 8. Spinal cord injuries 9. Neurological diagnostics (e.g., CT scan) 10. Lab values (e.g., coag panel, BMP) 11. Pharmacologic agents 12. Monitoring equipment (e.g., ICP monitor) VI. Cardiac 14% (14 items) 1. Multi-lead interpretation 2. Anatomy 3. Mechanical support device (e.g., Impella, ECMO, VAD, IABP) 4. Acute coronary syndromes (ACS) 5. Cardiogenic shock 6. Heart failure 7. Infectious cardiac disease (e.g., pericarditis, endocarditis, valvular disease) 8. Arrhythmias 9. Hypertensive crisis 10. Hemodynamic instability 11. Chronic cardiac conditions 12. Vascular disorders (e.g., AAA, thoracic dissection) 13. Electrophysiology 14. Cardiac diagnostics (e.g., ultrasound, cardiac echo) 15. Lab values (e.g., cardiac panel) 16. Pharmacologic agents Updated June 2023 – Controlled Document Page 9  Certified Flight Paramedic Candidate Handbook 17. Monitoring equipment VII. Trauma/Burn 12% (13 items) 1. Trauma/Burn diagnostics (e.g., CT x-ray, ultrasound) 2. Lab values 3. Pharmacologic agents 4. Monitoring equipment 5. Surgical interventions 6. Blood product administration and management 7. Lethal triad of trauma 8. Fluid resuscitation (e.g., burns) 9. Burns (e.g., thermal, electrical, chemical, radiological) 10. Toxic inhalation injuries VIII. Maternal Fetal and Neonatal 7% (8 items) 1. Maternal Fetal and Neonatal diagnostics (e.g., tocodynamometer) 2. Lab values 3. Pharmacologic agents 4. Monitoring equipment 5. Complications of delivery (e.g., cord prolapse, placental abruption) 6. Multiple-birth 7. Pre-eclampsia and Eclampsia 8. Premature Rupture of Membranes (PROM) 9. Maternal (1) Pregnancy induced hypertension (2) Hypertonic or tetanic contractions (3) HELLP (4) Retained products 10. Neonatal (1) Fluid/electrolyte (e.g., maintenance calculation) (2) General Isolette operations (3) Thermal management (4) Cardiac conditions (e.g., coarcation) (5) Surgical emergencies (e.g., NEC, diaphragmatic hernia, gastroschisis) (6) Respiratory Distress Syndrome (RDS) IX. Pediatric 8% (9 items) 1. Pediatric diagnostics 2. Lab values 3. Pharmacologic agents 4. Monitoring equipment 5. Airway disease (e.g., croup, RSV) 6. Nonaccidental trauma 7. Fluid/electrolyte replacement 8. Metabolic emergencies (e.g., DKA) 9. Special needs (e.g., developmental delays, autism spectrum, hematology-oncology) 10. High-tech (e.g., home vent) 11. Infectious disease (e.g., meningitis, re-emergent diseases) 12. Airway and ventilator management Updated June 2023 – Controlled Document Page 10  Certified Flight Paramedic Candidate Handbook X. Professional Considerations 6% (7 items) 1. Common accreditation standards 2. Research design, methodologies, and terminology 3. Privacy considerations 4. JUST culture 5. Evidence based medicine 6. Ethical considerations (e.g., end of life considerations, DNR) 7. GAMUT metrics 8. Caregiver PTSD and suicide risk TOTAL ITEMS = 110 END OF DETAILED CONTENT OUTLINE Updated June 2023 – Controlled Document Page 11  Certified Flight Paramedic Candidate Handbook FP-C SAMPLE QUESTIONS Acetaminophen poisoning is not associated with this smell. A 22-year-old male athlete is experiencing dyspnea, chest pain, and syncope with exertion. You are transporting a 21-year-old male who The 12-lead EKG reveals atrial fibrillation and was stabbed multiple times in the chest. He is left ventricular hypertrophy. You suspect cyanotic, and you observe jugular vein A. methamphetamine use.’ distention. After a liter fluid bolus of normal B. hypertrophic cardiomyopathy. saline, his vital signs are HR 120, RR 28, BP C. mitral valve stenosis. 60/50, and SpO2 94%. Which of the following is D. pericarditis. the most appropriate intervention? A. Administer norepinephrine Reference: Air Surface Patient Transport: Principles B. Perform a pericardiocentesis Practice 5th ed page 515 C. Administer phenylephrine D. Perform a left tube thoracostomy Rationale: Hypertrophic cardiomyopathy (HCM) is a genetically determined autosomal dominant disorder Reference: Critical Care Transport (2nd Ed) by the that causes abnormal development of cardiac American Academy of Orthopaedic Surgeons (AAOS), myocytes and intramural coronary arterioles. HCM the American College of Emergency Physicians patients are typically young (2nd or 3rd decade of life). (ACEP) and UMBC. (2017). Page 329-330 Left ventricular (LV) hypertrophy is a defining characteristic of HCM. Atrial fibrillation (AF) is the Rationale: Signs and symptoms of a cardiac most common dysrhythmia, both in the general tamponade are a narrowed pulse pressure, JVD and population and in patients with HCM. AF is common muffled heart tones. Of the choices only a with Mitral Stenosis as well but is usually manifested pericardiocentesis would benefit patient after volume in 4th or 5th decade of life rather than in young had been administered. previously healthy individuals. A 25-year-old male who is in septic shock An unresponsive 23-year-old female is having and has a serum lactate of 7.5 mg/dL and a MAP seizures of an unknown etiology. During your of 58 mmHg. To what lactate and MAP should assessment, you smell wintergreen emanating target your treatment? from her breath. Which of the following should A. 3.5 mg/dL and 60 mmHg you suspect? B. 5.0 mg/dL and 60 mmHg A. Hypermethioninemia C. 3.0 mg/dL and 65 mmHg B. Acetaminophen poisoning D. 5.5 mg/dL and 65 mmHg C. Diabetic ketoacidosis D. Methyl salicylate poisoning Reference: Critical Care Transport (2nd Ed) by the American Academy of Orthopaedic Surgeons (AAOS), Reference: Air Surface Patient Transport: Principles the American College of Emergency Physicians Practice 5th ed page 416 (ACEP) and UMBC. (2017). Page 276 Rationale: Methyl salicylate or oil of wintergreen has Rationale: Septic shock is defined as fluid a very distinctive odor, which emanates from the unresponsive hypotension requiring a vasopressor to breath of a patient poisoned by it. Methyl salicylate is maintain MAP of 65 mmHg or greater and serum contained in topical liniments to treat joint and lactate level greater than 2 mmol/L in the absence of muscular pain. Once absorbed in the body, it hypovolemia. metabolizes into salicylates, including salicylic acid, a known NSAID. Hypermethioninemia is an excess of methionine, an amino acid, which may cause a patient’s breath may smell of boiled cabbage. Updated June 2023 – Controlled Document Page 12  Certified Flight Paramedic Candidate Handbook A 28-year-old male is obtunded and has A 38-year-old female you are transporting by air extensive facial trauma following an MVC. His has an SpO2 of 98% on room air. During vital signs are HR 120, RR 6, BP 90/60, SpO2 transport, her SpO2 starts to decrease and you 93%, and EtCO2 50. You are unable to identify administer supplemental oxygen. Which of the any landmarks due to excessive bleeding and following explains the drop in her SpO2? edema. Now you are unable to get chest rise with A. Boyle’s Law an OPA and BVM ventilation. His current vital B. Dalton’s Law signs HR 140, RR 6, BP 84/56, SpO2 70%, EtCO2 C. Charles’ Law 60. You should D. Henry’s Law A. palpate and stabilize the cricothyroid membrane and Reference: Air and Surface Patient Transport: make a 5 to 7 cm vertical incision Principles Practice (5th ed.) (2017). Pag 24-25 through his skin. B. reposition his head and attempt a Rationale: Dalton’s Law – as altitude increases, the second intubation attempt with suction partial pressure decreases requiring oxygen at higher and a bougie. altitudes. C. palpate and stabilize the cricothyroid membrane and make a 5 to 7 cm horizontal incision through his skin. A 24-year-old male complains of a headache, D. reposition his head and attempt a nasal congestion, and his skin is flushed second intubation attempt with a and diaphoretic. He has a history of paraplegia smaller ET tube. secondary to a T3 severed spinal cord injury. His vitals are HR 45, RR 22, BP 214/120, and SpO2 Reference: Air and Surface Patient Transport: 98%. You should Principles Practice (5th ed.) (2017). Page 170-171 A. administer atropine. B. administer nitroprusside. Rationale: Failed airway algorithm states if SpO2 C. insert a foley catheter. drops below 93% at any point, ventilate with a D. insert a nasogastric tube. facemask and OPA/SGA. If no improvement of ETCO2 progress to surgical airway. The correct Reference: Critical Care Transport (2nd Ed) by the landmark is the cricothyroid membrane and should be American Academy of Orthopaedic Surgeons (AAOS), incised vertically. 5-7 cm horizontally would risk the American College of Emergency Physicians cutting adjacent vasculature. (ACEP) and UMBC. (2017). Page 413 Rationale: This patient is likely presenting with What are the daytime weather minimums of autonomic dysreflexia as evidenced by HTN, your non-mountainous rotor-wing base? bradycardia, and flushed diaphoretic face with A. 800 feet and 2 miles nasopharyngeal vessel congestion. A potential B. 800 feet and 3 miles precipitator of autonomic dysreflexia may be a full C. 1000 feet and 3 miles bladder and drainage of the bladder should be D. 1000 feet and 5 miles performed to rule out that as the cause. Atropine is not indicated as patient’s symptoms are not related to Reference: Critical Care Transport (2nd Ed) by the bradycardia. Nitroprusside may eventually be American Academy of Orthopaedic Surgeons (AAOS), indicated, but identification and correction of the American College of Emergency Physicians precipitating factors. (ACEP) and UMBC. (2017). chapter 4 page 77 Rationale: The flight visibility requirements for the daytime in a non-mountainous location is 800 feet and 2 miles Updated June 2023 – Controlled Document Page 13  Certified Flight Paramedic Candidate Handbook ON THE DAY OF YOUR EXAMINATION On the day of your examination appointment: To gain admission to RPT process, you must present For CBT testing – report to the Prometric Assessment acceptable photo identification. Identification must Center no later than your scheduled testing time. Once be valid and include your current name, signature, and you enter the Assessment Center, look for the signs photo. indicating Prometric Assessment Center Check-In. IF YOU ARRIVE MORE THAN 15 MINUTES Acceptable forms of primary identification include AFTER THE SCHEDULED TESTING TIME photo ID’s such as a current: YOU WILL NOT BE ADMITTED. 1. driver’s license 2. gov’t issued identification card To gain admission to the Assessment Center, you must 3. passport present acceptable photo identification. Identification 4. military identification card must be valid and include your current name, signature, and photo. You are prohibited from misrepresenting your identity or falsifying information to obtain admission to the Acceptable forms of primary identification include Assessment Center. photo ID’s such as a current: 1. driver’s license SECURITY 2. gov’t issued identification card IBSC and Prometric maintain examination 3. passport administration and security standards that are designed 4. military identification card to assure all candidates are provided the same opportunity to demonstrate their abilities. Each You are prohibited from misrepresenting your identity Prometric Assessment Center is continuously monitored or falsifying information to obtain admission to the by audio and video surveillance equipment for security Assessment Center. purposes. Candidates may be subjected to a metal detection scan upon entering the examination room. During CBT, MED, and RPT testing the computer monitors the time you spend on the examination. The examination will terminate if you exceed the time limit. The following security procedures apply during the A digital clock – located at the top of the screen – examination: indicates the time remaining for you to complete the Examinations are proprietary. No cameras, notes, examination. tape recorders, personal electronic devices, pagers, or cellular phones are allowed in the testing room Only one question is presented at a time. The question No guests, visitors, or family members are allowed in number appears on the left portion of the screen. The the testing room or reception areas entire question appears on-screen (i.e., stem and four All personal items will be placed in a locker and will options labeled – A, B, C and D). Indicate your not be accessible during the examination choice by either entering the letter of the For RPT testing – ensure your computer and internet option you think is correct (A, B, C or D) or connectivity meet the requirements outlined at clicking on the option using the mouse. Your https://rpcandidate.prometric.com/ answer appears in the highlighted window below the question. To change your answer, enter a different Sign into the ProProctor portal at least 15 minutes prior option by clicking on the option using the mouse. You to your scheduled appointment time at may change your answer as many times as you wish https://rpcandidate.prometric.com/ during the examination time limit. Updated June 2023 – Controlled Document Page 14  Certified Flight Paramedic Candidate Handbook To move to the next question, click on the next button in receive notification regarding rescheduling or the lower right portion of the screen. This action will reapplication procedures. move you forward through the examination question by question. If you wish to review any question or questions, If power to an Assessment Center is temporarily click the back button. interrupted during an administration, your examination will be restarted. The responses provided The “gear” icon on the bottom left of the screen allows up to the point of interruption will be intact, but for you to change the color of the pages. security reasons the questions will be scrambled. You may leave a question unanswered and return to it EXAMINATION RESTRICTIONS later. The “question mark” icon on the bottom of the page Possession of a cellular phone or other electronic will return you to the overall instruction page. To return devices (including smart watches) is strictly to the exam, click the "continue exam” icon on the prohibited and will result in dismissal from the bottom of the page. examination. You will be provided with a wipe-off board and marker You may flag questions for later review by clicking the to use during the examination. You must return the “flag” button at the bottom of the page. wipe-off board and marker to the Assessment Center staff at the completion of testing, or you will not You can eliminate answers by using the “strike-through” receive a score report. No documents or notes of any feature by right clicking on the mouse. To remove the kind may be removed from the Assessment Center. “strike-through” right click again. No questions concerning the content of the examination may be asked during the examination All unanswered and flagged questions will be noted on Eating, drinking, or smoking will not be the left side of the screen – next to the actual question permitted in the Assessment Center number. This will provide a list of flagged and You may take a break whenever you wish, but you unanswered questions. When you have completed the will not be allowed additional time to make up for examination, you will be prompted several times to exit time lost during breaks and finish the examination. Be sure to answer each question before ending the examination. There is no penalty for guessing. MISCONDUCT If you engage in any of the following conduct during INCLEMENT WEATHER OR EMERGENCIES the examination, you may be dismissed, and your In the event of inclement weather or unforeseen scores will not be reported. Examination fees will be emergencies on the day of an examination Prometric forfeited. Examples of misconduct include: will determine whether circumstances warrant the creating a disturbance, becoming abusive, or cancellation, and subsequent rescheduling, of an otherwise uncooperative; examination. The examination will usually not be display and/or use electronic communications rescheduled if the Assessment Center personnel are able equipment such as pagers, cellular phones, to open the Assessment Center. personal electronic device; talk or participate in conversation with other You may visit the Prometric website at examination candidates; www.Prometric.com prior to the examination to give or receive help or is suspected of doing so; determine if your Assessment Center has closed. Every leave the Assessment Center during the attempt is made to administer the examination as administration; scheduled; however, should an examination be canceled attempt to record examination questions or make at an Assessment Center, all scheduled candidates will notes; Updated June 2023 – Controlled Document Page 15  Certified Flight Paramedic Candidate Handbook attempt to take the examination for someone else; or the passing standard, the committee considers are observed with notes, books, or other aids. many factors, including relevant changes to the knowledge base of the field as well as changes in the Violation of any of the above provisions results in characteristics of minimally qualified candidates dismissal from the examination session. The for certification. candidate’s score on the examination is voided and examination fees are not refunded. Evidence of The passing standard for an exam is based on a misconduct is reviewed to determine whether the specified level of mastery of content in the specialty candidate will be allowed to reapply for examination. area. Therefore, no predetermined percentage of If re-examination is granted, a complete application examinees will pass or fail the exam. The committee and fee are required to reapply. sets a content-based standard, using the modified- Angoff method. FOLLOWING THE EXAMINATION The IBSC no longer provides the passing candidate FOR COMPUTER BASED and REMOTE with a raw score nor a breakdown of the PROCTOR TESTING: After you finish the examination score by topic area. Exam results are examination, you will be asked to complete a short reported pass/fail. If you did not pass the exam, you evaluation of your testing experience conducted by will receive an examination report indicating Prometric. Score reports will be e-mailed to the email subject areas of relative strength and weakness. The address used when registering, typically within one diagnostic report can assist you if you decide to hour of the examination. retake the exam. This change is necessary to FOR MOBILE EXAM DELIVERY (MED) endorse the philosophy that certification is the goal TESTING: After you finish the examination, you will and that the raw score number beyond the passing be asked to complete a short evaluation of your testing score does not matter. experience. Score reports can then be accessed, typically within one hour of the examination, at The domain scores on the score report is not used www.ScoreReports.Prometric.com. The candidate to determine pass-fail decision outcomes. They are will enter their examination confirmation number and only provided to offer a general indication name to access their score report. regarding your performance in each domain. The examination is designed to provide a consistent and SCORE REPORTING precise determination of your overall performance To pass any IBSC examination, your score must and is not designed to provide complete equal or exceed the passing score. The passing information regarding your performance in each standard for each IBSC exam is established using domain. You should remember that areas with a standard-setting techniques that follow best larger number of items will affect the overall score practices in the testing industry. more than areas with a fewer number of items. The precision and consistency of scores diminishes with The passing standard for each certification exam is fewer items, and therefore, sub-scores should be set by a designate IBSC Subspecialty Board, Test interpreted with caution, especially those that Committee or Subject Matter Expert Group. correspond to domains with very few items. Members of these groups are nationally recognized specialists whose combined expertise encompasses Numeric scores are not provided for examinees who the breadth of clinical knowledge in the specialty pass to ensure scores are not used for purposes area. Members include educators, managers, and other than licensure and certification. For example, providers, incorporating the perspectives of both numeric scores should not be used for hiring and the education and practice environments. In setting promotion decisions because the IBSC exams are Updated June 2023 – Controlled Document Page 16  Certified Flight Paramedic Candidate Handbook not designed for these purposes. candidate to direct their review and study material to address those domains in which you were not WHEN YOU PASS THE EXAMINATION successful. You may retake the examination after 30 When you pass the examination, your score report will days. The retesting process is outlined at state “pass” without a score breakdown. You will http://www.ibscertifications.org/resource/pdf/Retes receive a certificate and wallet card within 8 weeks ting%20Policy.pdf from our partners at The Award Group. Your certification lapel pin and patch will be sent under a separate mailing within 3 weeks of your testing date. SCORES CANCELLED BY THE IBSC OR Your FP-C certification is valid for a four-year period. PROMETRIC IBSC and Prometric are responsible for the integrity of IF YOU DO NOT PASS THE EXAMINATION the scores they report. On occasion, occurrences, such Should you fail the examination, additional detail is as computer malfunction or misconduct by a provided in the form of raw scores by major content candidate, may cause a score to be suspect. IBSC and category. A raw score is the number of questions you Prometric are committed to rectifying such answered correctly. As an example, in domain “A”, discrepancies as expeditiously as possible. the score of 7/12 means you correctly answered 7 of Examination results may be cancelled if, upon the 12 questions. Providing this data allows the investigation, a violation or discrepancy is discovered. Updated June 2023 – Controlled Document Page 17  Certified Flight Paramedic Candidate Handbook FP-C APPROVED ABBREVIATIONS Ab – Abortion HEMS – helicopter emergency medical services ABG – arterial blood gas HFOV – high frequency oscillatory ventilation AC – assist control HR – heart rate ACLS – Advanced Cardiac Life Support HTN – hypertension ALT – alanine aminotransferase IABP – intra-aortic balloon pump AST – aspartate aminotransferase ICP – Intracranial pressure ATC – air traffic control ICU – intensive care unit BP – blood pressure IDDM – insulin dependent diabetes mellitus BUN – blood urea nitrogen IFR – Instrument Flight Rules BVM – bag, valve, mask IIMC – Inadvertent instrument meteorological CABG – coronary artery bypass graft conditions CaCl – calcium chloride IM – intramuscular CAMTS – Commission on Accreditation of IO – intraosseous Medical Transport Systems I-time – inspiratory time CBC – complete blood count I-time – inspiratory time CEW – conducted energy weapon IV – intravenous CHF – congestive heart syndrome IVP – IV push Cl – chloride JVD – jugular venous distention CMV – conventional mechanical ventilation K+ – potassium CO – cardiac output KCL – potassium chloride CO2 – carbon dioxide kg – kilogram COPD – chronic obstructive pulmonary disease LOC – loss of consciousness CPAP – continuous positive airway pressure LZ – landing zone CPP – cerebral perfusion pressure MHz – Mega hertz CPR – cardiopulmonary resuscitation MI – myocardial infarction Cr – creatinine MSL – mean sea level CT – CAT scan, computerized axial tomography MVC – motor vehicle crash or collision CVP – Central venous pressure Na – Sodium DBP – diastolic blood pressure NaCl – sodium chloride DPL – diagnostic peritoneal lavage NC – nasal cannula DUI – driving under the influence NGT – nasogastric tube ED – emergency department NICU – neonatal intensive care unit EKG or ECG – electrocardiogram NiDDM – non-insulin dependent diabetes EMS – emergency medical services mellitus EtCO2 – carbon dioxide NRB – nonrebreather ETT – endotracheal tube NTSB – National Transportation Safety Board G – Gravida NVGs – night vision goggles g or gr – gram OGT – oral gastric tube GCS – Glasgow coma scale/score P – Para GI – gastrointestinal PAD – Pulmonary artery diastolic pressure GSW –gunshot wound HAA – helicopter air ambulance PAOP – Pulmonary artery occlusion pressure HCO3 – serum bicarbonate PAP – Pulmonary artery pressure HELLP syndrome – hemolytic anemia, elevated PAS – pulmonary artery systolic pressure liver enzymes, and low platelet count PCWP – pulmonary capillary wedge pressure Updated June 2023 – Controlled Document Page 18 PEEP – positive end-expiratory pressure PICU – pediatric intensive care unit PIH – pregnancy-induced hypertension PIP – peak inspiratory pressure PMH – past medical history PO – per os, orally PPE – personal protective equipment PROM – premature rupture of membranes PVR – pulmonary vascular resistance RDS – respiratory distress syndrome ROSC – return of spontaneous circulation RR – respiratory rate RSI – rapid sequence induction RVP – Right ventricular pressure SaO2 / Sats – SaO2, saturations, O2 sats SARS – severe acute respiratory syndrome SBP – systolic blood pressure SIMV – synchronized intermittent mandatory ventilation SpO2 – oxygen saturation SQ – subcutaneous SVR – systemic vascular resistance SVT – Supraventricular Tachycardia Temp or T – temperature tPA – tissue plasminogen activator TXA – Tranexamic acid VFR – Visual Flight Rules Vt or TV – tidal volume Vt or TV – tidal volume WBC – white blood cell WPW – Wolff-Parkinson-White syndrome Updated June 2023 – Controlled Document Page 19