Which item is not included in Tier I care?

• A. Ventilators.
• B. Infusion pumps.
• C. Chest tube maintenance.
• D. Cardiac stent placement by paramedics.

Answer: (D)

Tier I care covers the basic prehospital stabilization you can deliver with standard EMS equipment, focusing on keeping airway, breathing, and circulation supported during transport. Portable ventilators are designed for use on scene and en route, providing essential support for patients who need assisted breathing, so including ventilators fits within this level. Infusion pumps allow precise IV fluid and medication administration during transport, another fundamental capability in Tier I care. Chest tube maintenance involves caring for an already-inserted chest tube to prevent complications and ensure continued drainage during transport, which also aligns with the responsibilities at this level in many systems.

Cardiac stent placement by paramedics, on the other hand, is a highly specialized hospital-based procedure that requires an interventional cath lab, real-time imaging, and a multidisciplinary team. It’s beyond the scope of prehospital Tier I care, which is why this item is not included.