Maintains clinical competence across all aspects of scope of practice including, but not limited to, cardiac assist devices (IABP, Abio- med, Tandem Heart, Heartmate), ARDS treatment including advanced ventilator management and nitric oxide implementation, ECMO support, obstetric emergencies, trauma patient care across the lifespan, critical care across the lifespan, and any other patient population that is transported. Monitors and evaluates invasive and non-invasive procedures and their therapeutic effect, including the monitoring and operation of the fully functional critical care transport ventilator, ventricular assist devices (including, but not limited to, IABP, Abio-med, Tandem Heart, Heartmate), ECMO support, and ventriculostomies.