Basic requirements: flight nurse and flight paramedic

This is the CAMTS baseline for critical care transport crews, with flight RN and flight paramedic side by side. Last reviewed 2026-10-16.

Source: CAMTS Accreditation Standards, 13th Edition (first printed October 2026), the current edition listed on camts.org/standards. It replaces the 12th Edition from 2022. CAMTS posts a free version of the standards, which is what we used. That version leaves out the Education Matrix, glossary, and references, and it does not give an effective date. Everything below the "Typical employer requirements" heading comes from employers and certification boards, not CAMTS. CAMTS accreditation is voluntary, so programs without it may differ.
Flight nurse (RN)Flight paramedic
LicensureLicensed according to state and/or national requirements (CAMTS 03.01.03)Licensed according to state and/or national requirements (CAMTS 03.01.03)
Experience3 full-time-equivalent years, at least 4,000 hours, of critical care experience. CAMTS defines this as an ICU or emergency department.3 full-time-equivalent years, at least 4,000 hours, of ALS experience
Crew minimumAt least two licensed medical personnel plus a pilot or vehicle operator, and at least one must have the 3-year critical care experience. Clinicians also need pre-hire experience or education in the medications and interventions in the program's scope of care. (CAMTS 03.01.03)
Transport certificationCFRN or CTRN, pertinent to the scope of care, required for nurses employed more than 2 years. C-NPT for neonatal or pediatric teams.FP-C or CCP-C required for paramedics doing critical care transports and employed more than 2 years. A current paramedic certification such as Nationally Registered Paramedic is strongly encouraged for ALS/BLS crews.
Required courses (both roles, per scope of care)
  • BLS: AHA Healthcare Provider
  • ACLS: AHA. Not required for neonatal-only teams.
  • Trauma: ATLS, ATLS audit, ATCN, TNATC, TPATC, or an equivalent. TNCC counts toward the trauma course requirement.
  • Pediatrics: PALS, APLS, or ENPC
  • NRP or equivalent, if the team cares for high-risk OB or neonatal patients
  • Maternal Fetal Transport micro-credential within 2 years of hire, for clinicians dedicated to maternal fetal transports
CAMTS 03.05.01.3. Required certifications vary by state and program, since states can mandate which certs providers carry. Always check with the employer.
Initial orientationBoth crew members must complete a comprehensive initial training program, or show recent equivalent training, before working independently. Training does not have to be identical for both roles, but it must have "basic equivalencies," and both must be didactically trained. CAMTS sets required topics, not hours.
  • Transport topics: altitude physiology and stressors of flight, EMS radio communications, scene safety and extrication, infection control, oxygen safety, state EMS rules, vehicle and aircraft safety
  • Clinical topics: advanced airway, mechanical ventilation, cardiac critical care, trauma, burns, OB, neonatal and pediatric emergencies, neuro, sepsis, shock, toxicology, pharmacology, and more
  • Clinical experiences with measurable objectives: critical care, emergency care, and invasive procedure labs. Simulation is allowed with documentation.
  • Safety education at hire and every year: aircraft safety and evacuation, emergency landing, ground operations and hot loading, hazmat, survival and egress
CAMTS 03.05.01.1 and 03.05.02
Continuing educationDocumented every year for all critical care and ALS providers.
  • Annual didactic: crew resource management (AMRM), exposure control, fatigue and sleep, drug diversion, state EMS rules, stress and resilience
  • Annual clinical and lab: critical care, emergency and trauma care, invasive procedure labs, high-risk OB
  • At least 1 airway management experience per quarter for each airway type in the protocols and each age group in the program's scope of care
CAMTS 03.05.01.2

Certification board eligibility

CFRN (BCEN)

Requires a current, unencumbered RN license in the US, a US territory, Canada, or Australia. BCEN recommends 2 years of specialty experience but does not require it. BCEN CFRN eligibility

FP-C / CCP-C (IBSC)

Requires a current, unrestricted paramedic license. IBSC recommends about 3 years of experience in a busy ALS system. To renew FP-C by continuing education, you need 100 approved CE credits per 4-year cycle, including a 16-hour approved review course. IBSC exam requirements · FP-C recertification

Typical employer requirements (not CAMTS)

Individual programs often require more than the CAMTS baseline. These are common in job postings and association guidance. Always check the specific posting.

Flight nurse

  • Usually 3–5 years of ICU and/or ED experience. Some programs prefer ICU, and some want prehospital experience too.
  • Commonly asked for: BLS, ACLS, PALS, NRP, and TNCC or TPATC
  • Some states or programs require EMT certification
  • CFRN within about 2 years, sometimes sooner

Flight paramedic

  • Usually 3+ years in a busy 911 or ALS system. Some programs ask for 5 years.
  • Commonly asked for: BLS, ACLS, PALS, NRP, and PHTLS or ITLS
  • National Registry often preferred. Critical care or interfacility experience is a plus.
  • FP-C within about 2 years, sometimes sooner

Typical-requirement sources: ASTNA FAQ, FlightParamedic.org (IAFCCP-affiliated resource), and current job postings from Air Methods, GMR, and UCHealth. Secondary summaries of the CAMTS certification rule: BCEN. This page is general information, not legal or credentialing advice. Your program's medical director and job posting are the final word.