**Specialty: Critical Care Advanced Practice Provider (APP)**

**Scope of Practice:** - **Setting:** Inpatient rounds only.  

**Procedural Competencies:**

- Proficient in moderate sedation.

- Skilled in performing lumbar punctures.

- Competent in endotracheal intubation and extubation.

- Experienced in paracentesis and thoracentesis.

- Ventilator management expertise includes:  

- Assessing patient readiness for respiratory weaning and oxygen therapy.  

- Assessing the necessity for intubation.

- Chest tube insertion capabilities.

- Insertion of various access lines including PICC lines, arterial lines, and central venous catheters, either percutaneously or via cutdown technique.

- Arterial line insertion and removal (both radial and femoral), recognizing that these privileges may overlap.

- Proficient in tracheostomy care, including tube replacement.

- Management of tension pneumothorax in emergent scenarios.

- External pacing, including adjustments to temporary epicardial, transvenous, or transcutaneous pacemakers as needed.

**Proctoring Requirements:** - Must complete 5 supervised cases for each procedure listed.

**Clinical Support:** - Available.

**Electronic Medical Record (EMR) and Dictation Tools:**

- Utilizes EPIC and Dragon for documentation.

**Mandatory Qualifications:** - Current ACLS certification.

- Demonstrated experience: Minimum of 50 case logs within the past 12 months.

- Board Certification (or valid Board Eligibility).

- Clean OIG search.

- Holds an active Michigan medical license or is part of the Interstate Medical Licensure Compact (IMLC).