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Exam Review

Key Facts: FP-C Exam

135

Total Questions

IBSC

110

Scored Items

IBSC

2.5h

Exam Time

IBSC

$285/$385

Exam Fee

IBSC 2026

4 years

Certification Valid

IBSC recertification cycle

The FP-C exam contains 135 questions (110 scored) administered over 2.5 hours. Content covers critical care transport medicine with emphasis on altitude physiology, advanced airway management, cardiac emergencies, and trauma resuscitation. The exam is designed for experienced paramedics working in air medical transport. IBSC recommends 3+ years of critical care transport experience before testing.

Sample FP-C Practice Questions

Try these sample questions to review concepts for the FP-C exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 255+ question experience with AI tutoring.

1According to Boyle's Law, what happens to a gas pocket in the pleural space during ascent to 8,000 feet?
A.The gas pocket will decrease in volume by 25%
B.The gas pocket will remain unchanged regardless of altitude
C.The gas pocket will expand due to decreased atmospheric pressure
D.The gas will be absorbed by surrounding tissues at altitude
Explanation: At constant temperature, pressure and volume are inversely related. In the standard atmosphere, a fall from about 760 mmHg at sea level to about 565 mmHg at a cabin altitude of 8,000 feet would increase the volume of freely expanding trapped gas by about 35% (760 ÷ 565 ≈ 1.35). An expanding pneumothorax can compromise ventilation and circulation, especially with positive-pressure ventilation.
2A patient with a traumatic brain injury has a small pneumocephalus identified on CT scan. What is the primary concern regarding air transport?
A.The patient will experience increased oxygen toxicity at altitude
B.Intracranial air will expand, potentially causing increased ICP
C.Lower oxygen levels will worsen the brain injury
D.Vibration from the aircraft will worsen the injury
Explanation: When cabin pressure falls, intracranial gas can expand and raise intracranial pressure. Discuss cabin pressure limits, route and transport mode with the treating and receiving specialists. The decision depends on the size and cause of the pneumocephalus and the patient’s neurologic condition.
3In the standard atmosphere at 10,000 feet, total dry ambient pressure is about 523 mmHg. Which law gives oxygen partial pressure as 0.21 × 523 mmHg?
A.Boyle's Law
B.Charles's Law
C.Dalton's Law
D.Henry's Law
Explanation: Dalton’s law relates a gas’s partial pressure to its fraction of the mixture and the mixture’s total pressure. At 10,000 feet, 0.21 × 523 ≈ 110 mmHg in dry ambient air. At sea level, 0.21 × 760 ≈ 160 mmHg. Lower ambient pressure reduces oxygen partial pressure even though the oxygen fraction is essentially unchanged.
4Under the CAMTS 12th-edition fixed-wing standard, how should the team determine a safe cabin altitude for a patient with a pressure-sensitive condition?
A.Apply a single 5,000-foot limit to all patients
B.Use physician guidance or disease-specific altitude policy
C.Use the aircraft’s cruising altitude as the patient’s altitude limit
D.Apply the flight crew’s oxygen threshold to the patient
Explanation: CAMTS section 06.02.02 calls for consultation with a physician familiar with altitude physiology or written policies addressing altitude limits for the patient’s condition. Cabin pressure altitude determines exposure, and a patient with trapped gas may need a much lower cabin altitude than another patient on the same aircraft.
5During a weather-related divert, the pilot and medical crew disagree on whether to continue to the destination or land at the alternate. Which Crew Resource Management (CRM) principle should be applied?
A.Let the pilot decide without hearing the medical assessment
B.Share both assessments and respect the pilot’s flight authority
C.Let the most senior clinician decide where the aircraft lands
D.Ask the sending physician to decide if the aircraft can continue
Explanation: Crew Resource Management (CRM) emphasizes collaborative decision-making while maintaining clear lines of authority. In this scenario, the pilot has final authority regarding aircraft safety and airworthiness, but CRM principles require that all crew members contribute relevant information. The medical crew can provide input on patient stability and urgency, while the pilot provides expertise on weather, fuel, and aircraft capabilities. This collaborative approach leads to safer, more informed decisions.
6A 45-year-old patient requires rapid sequence intubation in flight. There is no known contraindication to succinylcholine. Which regimen pairs a usual adult induction dose with a rapid-onset neuromuscular blocker?
A.Midazolam 10 mg IV after succinylcholine 1.5 mg/kg IV
B.Etomidate 0.3 mg/kg IV followed by succinylcholine 1.5 mg/kg IV
C.Propofol 2.5 mg/kg IV without a neuromuscular blocker
D.Ketamine 2 mg/kg IV without a neuromuscular blocker
Explanation: Etomidate provides induction, followed by succinylcholine to produce rapid paralysis when appropriate. Altitude increases the importance of preoxygenation and managing the short safe apnea time. Select the induction and paralytic agents for the patient’s physiology and contraindications, and provide post-intubation analgesia and sedation.
7A transport ventilator has automatic altitude compensation and remains within its specified operating range. What is the best approach during ascent?
A.Increase the respiratory rate in proportion to altitude
B.Reduce FiO2 to maintain the original delivered tidal volume
C.Increase inspiratory time in proportion to altitude
D.Keep the ordered tidal volume and verify delivery on the monitor
Explanation: An altitude-compensated ventilator adjusts its gas delivery for ambient pressure within its specified operating limits. Verify exhaled tidal volume, pressures, oxygenation and ventilation throughout the flight. Different models compensate differently and have different operating ranges.
8A patient with a difficult airway requires a surgical cricothyrotomy during flight. What is the correct anatomical location for the incision?
A.Through the thyroid cartilage
B.Through the cricothyroid membrane
C.Through the cricoid cartilage
D.Below the cricoid at the first tracheal ring
Explanation: The cricothyroid membrane lies immediately below the thyroid cartilage and above the cricoid cartilage. In an adult who cannot be intubated or oxygenated, emergency front-of-neck access can be made through this membrane. The tube passes into the airway, where sustained waveform capnography helps confirm ventilation.
9An intubated adult has a reliable SpO2 of 82% on FiO2 0.40. The airway and circuit are patent, and the team is checking for the cause of worsening oxygenation. Which setting can raise inspired oxygen immediately without first increasing airway pressure?
A.Increase the respiratory rate to 18
B.Increase PEEP to 8-10 cm H2O
C.Increase FiO2 and reassess the oxygen response
D.Decrease tidal volume to 400mL
Explanation: Increasing FiO2 raises the inspired oxygen fraction immediately without raising PEEP. Assess for reversible causes of desaturation in parallel and titrate oxygen back once stable. PEEP may help recruit lung units when indicated. A low PaO2/FiO2 ratio alone cannot establish an ARDS diagnosis.
10During RSI, an adult develops a heart rate of 42 bpm and hypotension after succinylcholine. Oxygenation and ventilation are being supported and a pulse is present. What is the initial atropine dose for persistent symptomatic bradycardia?
A.Atropine 1 mg IV
B.Atropine 0.5 mg IV
C.Atropine 0.02 mg/kg IV
D.Atropine 3 mg IV
Explanation: The adult AHA bradycardia algorithm uses atropine 1 mg IV initially. Repeat every 3–5 minutes if needed, up to 3 mg total. Correct reversible causes, including hypoxia, and prepare to escalate to transcutaneous pacing or a vasoactive infusion if clinically significant bradycardia persists.

About the FP-C Exam

The FP-C certification validates advanced knowledge of critical care transport medicine for flight paramedics. The exam covers 10 domains: Safety and Transport (8%), Flight Physiology (6%), Airway, Anesthesia, and Analgesics (15%), Medical Emergencies (13%), Neurological (11%), Cardiac (13%), Trauma/Burn (12%), Maternal Fetal and Neonatal (7%), Pediatric (8%), and Professional Considerations (6%). The exam consists of 135 items (110 scored, 25 unscored pretest).

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

73 of 110 scored items (~66% raw)

Exam / Certification Fees

$285 affiliate members; $385 non-members

Exam sponsor website

Reported exam pass rate: 57.6% (IBSC 2024 annual report, FP-C).. 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.

8%

Safety and Transport

Aircraft operations, safety systems, risk assessment, weather, and mission transport safety.

6%

Flight Physiology

Gas laws, altitude physiology, hypoxia, cabin pressure, and stressors of flight.

15%

Airway, Anesthesia, and Analgesics

Advanced airway strategy, ventilation, pharmacology, and peri-intubation management.

13%

Medical Emergencies

Complex medical conditions, diagnostics, invasive lines, and transport-critical interventions.

11%

Neurological

Neuro assessment, neurotrauma, stroke, seizure, and neuroprotective management.

13%

Cardiac

ACS, arrhythmias, cardiogenic shock, hemodynamics, and mechanical cardiac support.

12%

Trauma/Burn

Trauma diagnostics, blood products, burn physiology, and high-acuity stabilization.

7%

Maternal Fetal and Neonatal

Perinatal transport emergencies, maternal complications, and neonatal stabilization.

8%

Pediatric

Pediatric transport pathologies, airway challenges, and age-adjusted intervention decisions.

6%

Professional Considerations

Accreditation standards, ethics, research literacy, and quality/performance metrics.

Preparing for the FP-C Exam

What You Need to Know

  • Passing score: 73 of 110 scored items (~66% raw)
  • Exam length: 135 questions
  • Time limit: 2.5 hours
  • Exam / certification fees: $285 affiliate members; $385 non-members Official sources

Using Our Practice Resources

  • Work through all 255 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

FP-C: Suggested Study Strategy

1Master altitude physiology and gas laws - key difference between FP-C and ground critical care
2Practice RSI scenarios and difficult airway algorithms specific to transport environment
3Know vasoactive medication dosing and titration for flight transport
4Study TBI management protocols including hyperosmolar therapy and ICP targets
5Understand burn calculation formulas (Parkland) and fluid resuscitation
6Review CAMTS safety standards and crew resource management principles
7Practice ABG interpretation and ventilator management
8Study OB emergencies including preeclampsia and neonatal resuscitation

Frequently Asked Questions

What is the FP-C exam?

The FP-C (Flight Paramedic-Certified) is a specialty certification offered by IBSC (International Board of Specialty Certification) that validates advanced knowledge of critical care transport medicine for flight paramedics working in rotor-wing and fixed-wing air medical transport.

How many questions are on the FP-C exam?

The FP-C exam contains 135 total questions: 110 scored items and 25 unscored pretest items. You have 150 minutes (2.5 hours) to complete the computer-based exam.

What is the FP-C passing score?

IBSC uses a scaled scoring system. IBSC uses a scaled scoring system with a raw cut score of 73 of 110 scored items to pass; the standard is set by the certification body.

What are the FP-C eligibility requirements?

You must hold a current, unrestricted paramedic license. IBSC recommends 3+ years of critical care transport experience. While not required, many successful candidates have experience in ICU, emergency department, or air medical transport settings.

What content areas are covered on the FP-C exam?

The FP-C exam covers 10 domains: Safety and Transport (8%), Flight Physiology (6%), Airway, Anesthesia, and Analgesics (15%), Medical Emergencies (13%), Neurological (11%), Cardiac (13%), Trauma/Burn (12%), Maternal Fetal and Neonatal (7%), Pediatric (8%), and Professional Considerations (6%).

How long is FP-C certification valid?

FP-C certification is valid for 4 years. Recertification can be achieved through continuing education or by retaking the exam. IBSC requires ongoing professional development to maintain certification.

How should I prepare for the FP-C exam?

Study systematically across all 10 domains. Focus on the largest domains: Airway, Anesthesia, and Analgesics (15%), Cardiac (13%), and Medical Emergencies (13%). Master altitude physiology and gas laws, which are unique to flight medicine. Use critical care transport textbooks and practice questions. Plan for 3-6 months of dedicated study time.