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Key Facts: CCP-C Exam

135

Total Questions

IBSC

68/110

Passing Score

IBSC FAQ

2.5h

Exam Time

IBSC

$385

Exam Fee

IBSC Store

72%

Pass Rate (2022)

IBSC reported

4 years

Certification Valid

IBSC recertification

The CCP-C exam contains 135 questions (110 scored) administered over 2.5 hours with a passing score of 68 correct answers. Airway, Anesthesia, and Analgesics is the largest domain at 14 scored items, making it the most heavily tested area. The 2022 reported pass rate is 72%. Critical care paramedics earn $60,000-$85,000 on average, with CCP-C certified professionals often commanding higher salaries in ground and air transport programs.

Sample CCP-C Practice Questions

Try these sample questions to review concepts for the CCP-C exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 138+ question experience with AI tutoring.

1A critical care transport crew is preparing to transfer a ventilated patient from an ICU to a receiving facility 45 minutes away. During the pre-transport checklist, the crew discovers the portable ventilator battery shows 60% charge. What is the MOST appropriate action?
A.Proceed with transport since 60% battery is sufficient for 45 minutes
B.Replace or fully charge the battery before departing and verify backup power
C.Switch the patient to a bag-valve mask for transport to conserve battery
D.Request a shorter transport route to reduce battery drain
Explanation: Pre-transport equipment checks must ensure all devices have full battery capacity plus backup. A 60% charge may be insufficient when accounting for unexpected delays, transport time variability, and increased ventilator demands. The crew should replace or fully charge the battery and verify backup power sources are available before departing.
2During a critical care interfacility transport, the flight nurse and paramedic disagree about the need to increase the vasopressor dose. Which crew resource management principle should guide their interaction?
A.The paramedic should defer to the nurse's judgment since nurses have higher licensure
B.The disagreement should be tabled until arrival at the receiving facility
C.Both crew members should use assertive communication to share concerns and reach a collaborative decision
D.The pilot or driver should make the final medical decision to avoid conflict
Explanation: Crew resource management (CRM) emphasizes open, assertive communication among all team members regardless of role or hierarchy. Both the nurse and paramedic should clearly state their clinical rationale, share concerns, and collaboratively reach a decision that prioritizes patient safety. CRM training reduces errors by ensuring all perspectives are heard.
3A transport crew is conducting a risk assessment before accepting a nighttime ground transport of a critically ill patient through mountainous terrain. Which risk assessment tool is commonly used in transport medicine to evaluate mission hazards?
A.Glasgow Coma Scale
B.APACHE II scoring system
C.Risk assessment matrix (RAM) or go/no-go checklist
D.Sequential Organ Failure Assessment (SOFA) score
Explanation: Risk assessment matrices (RAM) and go/no-go checklists are standard tools used in transport medicine to systematically evaluate mission hazards including weather, terrain, crew fatigue, equipment status, and patient acuity. These tools help crews make objective safety decisions rather than relying on subjective judgment alone.
4Which of the following stressors is MOST likely to affect both the patient and crew during prolonged ground critical care transport?
A.Hypoxia from altitude changes
B.Vibration causing motion artifacts on monitoring equipment
C.Decreased barometric pressure expanding trapped gases
D.Solar radiation exposure through aircraft windows
Explanation: Vibration is a significant stressor during ground transport that affects both patients and crew. It can cause motion artifacts on cardiac monitors and pulse oximeters, increase patient pain and anxiety, contribute to crew fatigue, and potentially dislodge lines and tubes. Transport crews must secure all equipment and account for vibration-related monitoring interference.
5A critical care paramedic is preparing to perform rapid sequence intubation (RSI) on a hemodynamically unstable patient. Which induction agent is MOST appropriate for this patient?
A.Propofol 2 mg/kg IV
B.Midazolam 0.3 mg/kg IV
C.Ketamine 1.5 mg/kg IV
D.Thiopental 3 mg/kg IV
Explanation: Ketamine is the preferred induction agent for hemodynamically unstable patients because it provides dissociative anesthesia while maintaining sympathetic tone, supporting blood pressure and heart rate. Propofol and thiopental cause significant hypotension through vasodilation and myocardial depression. Midazolam has unpredictable onset and also contributes to hypotension.
6During transport, a mechanically ventilated patient on volume-controlled ventilation suddenly develops high peak airway pressures with normal plateau pressures. What is the MOST likely cause?
A.Tension pneumothorax
B.Kinked or obstructed endotracheal tube
C.Worsening ARDS with decreased lung compliance
D.Pulmonary embolism
Explanation: When peak airway pressure is elevated but plateau pressure remains normal, the problem is increased airway resistance rather than decreased lung compliance. A kinked or obstructed endotracheal tube, mucus plugging, or bronchospasm are common causes of increased resistance. Conditions that decrease compliance (ARDS, pneumothorax) would elevate both peak and plateau pressures.
7Which neuromuscular blocking agent has the SHORTEST duration of action and is preferred for RSI when a short-acting paralytic is desired?
A.Rocuronium 1.2 mg/kg
B.Vecuronium 0.1 mg/kg
C.Succinylcholine 1.5 mg/kg
D.Cisatracurium 0.2 mg/kg
Explanation: Succinylcholine is a depolarizing neuromuscular blocker with the shortest duration of action (5-10 minutes), making it the classic choice when a brief period of paralysis is desired. This allows for rapid return of spontaneous ventilation if intubation fails. However, it is contraindicated in patients with hyperkalemia, burns >24 hours, crush injuries, and certain neuromuscular diseases.
8A critical care paramedic is managing a patient on pressure-controlled ventilation with settings of PC 20, PEEP 10, RR 16, FiO2 0.6. The patient's SpO2 is 88% and PaO2 is 55 mmHg. What is the MOST appropriate initial ventilator adjustment?
A.Increase the respiratory rate to 24
B.Increase PEEP to 14 cmH2O
C.Increase FiO2 to 1.0
D.Switch to volume-controlled ventilation
Explanation: With persistent hypoxemia on a moderate FiO2 (0.6), increasing PEEP is often the most effective strategy. PEEP recruits collapsed alveoli, improves functional residual capacity, and enhances oxygenation. While increasing FiO2 is a rapid temporizing measure, it does not address the underlying atelectasis and prolonged high FiO2 can cause oxygen toxicity. The ARDSNet protocol recommends titrating PEEP in conjunction with FiO2.
9During RSI, which of the following is the CORRECT order of steps?
A.Paralytic, induction agent, preoxygenation, intubation
B.Preoxygenation, induction agent, paralytic, intubation
C.Induction agent, preoxygenation, paralytic, intubation
D.Preoxygenation, paralytic, induction agent, intubation
Explanation: The correct RSI sequence begins with preoxygenation (3-5 minutes of 100% O2 to create an oxygen reserve), followed by administration of the induction agent (to achieve unconsciousness), then the paralytic agent, and finally intubation once paralysis is achieved. This sequence ensures the patient is unconscious before paralysis and has adequate oxygen reserves to prevent desaturation during the apneic period.
10A transport ventilator alarms for low tidal volume delivery. The patient is intubated with an 8.0 ETT and the cuff pressure is 22 cmH2O. Auscultation reveals diminished breath sounds bilaterally with a leak heard over the neck. What is the MOST likely problem?
A.Right mainstem intubation
B.ETT cuff leak or herniation
C.Circuit disconnection at the ventilator
D.Mucus plugging of the ETT
Explanation: An audible leak over the neck with low tidal volume delivery strongly suggests an ETT cuff leak or cuff herniation above the vocal cords. The cuff pressure of 22 cmH2O appears adequate but may indicate a damaged or herniating cuff that cannot maintain a seal. The crew should attempt to add air to the cuff; if the leak persists, ETT replacement is indicated.

About the CCP-C Exam

The CCP-C certification validates advanced knowledge of critical care transport medicine for ground and air paramedics. The exam covers 12 domains led by Airway, Anesthesia, and Analgesics (13%), Cardiac Patient (12%), and General Medical, Respiratory, and Trauma/Burn Patient (10% each). Candidates face 135 items (110 scored, 25 unscored pilot) in 2.5 hours. The certification targets master-level paramedics providing patient care in pre-hospital, inter-hospital, and hospital critical care environments.

Exam sponsor: IBSC (International Board of Specialty Certification). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

135 questions

Time Limit

2.5 hours

Passing Score

68/110 scored items (~62%)

Exam / Certification Fees

$385

Exam sponsor website

Reported exam pass rate: 72% (2022 reported). This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

13%

Airway, Anesthesia, and Analgesics

Airway assessment, pharmacology, medication-facilitated airway management, failed and difficult airway algorithms, surgical airway, mechanical ventilation, NIPPV, tube confirmation, and waveform capnography.

12%

Cardiac Patient

Multi-lead ECG, assist devices (Impella, ECMO, VAD, IABP, pacemakers), ACS, cardiogenic shock, heart failure, arrhythmias, hypertensive emergencies, vascular disorders, and post-cardiac arrest care.

10%

Trauma/Burn Patient

Burns and inhalation injuries, isolated and multi-system trauma, thoracostomy, pericardiocentesis, escharotomy, blood products, REBOA, fluid resuscitation, and pain management.

10%

General Medical Patient

Endocrine, renal, gastrointestinal, acid-base, and infectious disorders (including sepsis), blood products, fluid resuscitation, lab values, invasive lines, hemodynamic monitoring, and radiographs.

10%

Respiratory Patient

Pulmonary physiology, ARDS, pneumothorax, pneumonia and other infections, asthma and COPD, pulmonary edema, pulmonary embolism, radiographs, and chest drainage systems.

9%

Neurological Patient

Neurological assessment, seizures, altered mental status, large vessel occlusion, cerebral hemorrhage, traumatic brain and spinal cord injury, neuroprotective strategies, EVD management, and ICP monitoring.

8%

Pediatric Patient

Pediatric airway and ventilation, DKA, sepsis, meningitis, cardiac and neurologic disorders, croup and RSV, toxic exposures, trauma and burns, special needs, and fluid and electrolyte replacement.

7%

Maternal/Fetal Medicine

Obstetric complications (cord prolapse, placental abruption, preeclampsia, HELLP, PROM, postpartum hemorrhage), obstetric maneuvers, and neonatal patients, including congenital heart disease and prematurity.

6%

Transport and Safety

Personal wellness and fitness for duty, communication and radio operations, safety and restraint systems, risk assessment, crew resource management, and stressors of transport.

5%

Toxic Exposure and Environmental Patient

Environmental exposure, CBRNE injuries, dive and altitude illness, flora and fauna reactions, toxicology, overdose, adverse drug reactions, and poisoning.

5%

Special Populations

Bariatric patients (anatomy, transport equipment, drugs, monitoring) and geriatric patients (age-related changes, end-of-life decisions, lab values, and pharmacology).

5%

Professional Considerations

Accreditation standards, research design and terminology, Just Culture, evidence-based medicine, ethics including DNR, GAMUT quality metrics, and cultural and diversity considerations.

Preparing for the CCP-C Exam

What You Need to Know

  • Passing score: 68/110 scored items (~62%)
  • Exam length: 135 questions
  • Time limit: 2.5 hours
  • Exam / certification fees: $385 Official sources

Using Our Practice Resources

  • Work through all 138 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

CCP-C: Suggested Study Strategy

1Prioritize Airway, Anesthesia, and Analgesics — at 14 scored items it is the largest domain, just ahead of Cardiac Patient (13)
2Master RSI pharmacology including induction agents, paralytics, and push-dose pressors
3Know ventilator modes (AC, SIMV, PRVC, APRV) and troubleshooting high-pressure alarms
4Study hemodynamic monitoring including arterial lines, CVP, and PA catheter waveforms
5Understand vasoactive drip calculations and titration (norepinephrine, vasopressin, dobutamine)
6Review massive transfusion protocols and blood product administration ratios
7Practice neonatal and pediatric weight-based drug dosing and Broselow tape use
8Know IABP timing, VAD troubleshooting, and mechanical circulatory support transport protocols

Frequently Asked Questions

What is the CCP-C exam?

The CCP-C (Certified Critical Care Paramedic) is a specialty certification offered by the International Board of Specialty Certification (IBSC). It validates advanced knowledge and skills required to care for critically ill or injured patients during ground and air critical care transport.

How many questions are on the CCP-C exam?

The CCP-C exam contains 135 total questions: 110 scored items and 25 unscored pilot items. You have 2.5 hours (150 minutes) to complete the computer-based exam at a Prometric testing center, by remote proctoring on Prometric ProProctor, or at an IBSC on-site mobile exam session.

What is the CCP-C passing score?

The CCP-C passing score is 68 correct answers out of 110 scored items, which is approximately 62%. The 25 unscored pilot items do not count toward your score and cannot be distinguished from scored items during the exam.

What are the CCP-C eligibility requirements?

You must hold a current, unrestricted paramedic license in your state or country of practice. IBSC recommends at least 3 years of experience in a busy ALS system and significant knowledge of ACLS, PALS, NRP, and ITLS/PHTLS standards.

How much does the CCP-C exam cost?

The CCP-C exam costs $285 for affiliate members and $385 for non-members. Exam fees are non-refundable. A $100 fee applies for switching exam type or rescheduling within 30 days of your confirmed testing date.

What is the difference between CCP-C and FP-C?

Both are IBSC certifications for critical care paramedics. The CCP-C focuses on ground and general critical care transport, while the FP-C (Flight Paramedic-Certified) includes additional content on flight physiology, altitude effects, and aircraft safety. Many paramedics hold both certifications.

How long is CCP-C certification valid?

CCP-C certification is valid for 4 years. Recertification requires either 100 approved continuing education hours (including a 16-hour approved review course) or retaking and passing the exam. A $125 late processing fee applies if CE documentation is submitted less than 30 days before expiration.