Definitions of different levels of ground transport systems
| Minimum requirements of ambulance and equipment | Minimum requirements of first team member | Minimum requirements of second team member | |
|---|---|---|---|
| System A (high) | MICU/ITW* | Intensivist† | ICU nurse IC paramedic‡ |
| System B (medium) | IC ambulance§ | ICU physician¶ | Paramedic |
| System C (low) | Standard ambulance | Physician | Paramedic |
*High volume ambulance equipped with: a boarding ramp, ICU ventilation equipment as well as standard ambulance equipment, a minimum of six infusion pumps, invasive monitoring equipment, the ability to reach the patient from all sides, the ability to transport patients with additional medical devices (such as ECMO, NO, IABP), back-up systems for a ventilator/monitoring/defibrillation unit/suction unit and at least 6000 L of oxygen (or 6000 L of pressurised oxygen, if required by the particular ventilator system). The unit must also have a stand-alone capacity of at least 120 min.
†Board certified Intensivist.
‡Paramedic with additional intensive care qualification.
§Standard ambulance equipped with: a standard ambulance equipment, an ICU transport ventilator, a minimum of four infusion pumps, invasive monitoring equipment and 2000 L of oxygen. The unit must also have a stand-alone capacity of at least 60 min.
¶FCCS or a similarly trained physician with at least 6 months intensive care experience.
ECMO, extracorporeal membrane oxygenation; FCCS, fundamental critical care support; IABP, intra-aortic balloon pump; IC, intensive care; ICU, intensive care unit; ITW, Intensivtransportwagen; MICU, Mobile Intensive Care Units; NO, nitric oxide.