This document aims to describe the levels of care required for critically ill patients according to their clinical needs, regardless of patient location. The ensuing descriptions align with other jurisdictions and literature. While acuity and complexity should be considered when analyzing patient care needs, those terms are combined for simplicity and are referred to as 'Levels of Adult Critical Care'.  

• Levels of Care - Adult Critical Care
• Overview of CCBC Levels of Care - Adult Critical Care

For any questions about this document or how the data is being collected and/or used, please reach out to Sybil Hoiss, CCBC Lead, Clinical Initiatives and Innovation at sybil.hoiss@phsa.ca.

ICU Liberation refers to key clinical elements aimed at reducing pain, oversedation, delirium, mechanical ventilation, immobility, isolation, sleep disturbances, and ICU acquired weakness. These experiences contribute to life altering post discharge residual effects, or Post Intensive Care Syndrome (PICS), and are modifiable.

ICU Liberation aims to improve patient and family involvement and encourage interdisciplinary team communication. ICU Liberation Bundle Elements are most effective when implemented by an interdisciplinary team and unit champions. 

A - Assess, Prevent and Treat Pain (resources coming soon)

B - Both Spontaneous Awakening Trials and Spontaneous Breathing Trial

• CCBC ICU Liberation B - Both SATs and SBTs Feb 21 2025.pdf

      Data Tracking forms for use at paper based sites:

• Vent audit VIHA_2025 02 07.xlsx
  
• SAT Audit.docx
  
• Extubation Quality Improvement Tool.docx

C- Choice of Analgesic and Sedation (resources coming shortly)

D- Delirium – Assess, Prevent and Manage (resources coming soon)

E – Early Mobility and Exercise (resources coming soon)

F – Family Engagement and Empowerment  (resources coming soon)‎

Critical Care BC (CCBC) would like to draw attention to key resources available to health care disciplines in BC. Learn more here.‎

• Pediatric Critical Care in British Columbia | CHBC (childhealthbc.ca)

• Provincial ECLS transport standard workflow
• Provincial ECMO transport process checklist
• Escalating Care Pathway for ARDS and VV ECLS: Evaluation, Triage and Management 
  

Provincial Emergency Fleet is a provincially owned stockpile of medical devices intended to help hospitals manage unexpected increases in demand for critical care resources.  Regional Health Authorities can request these medical devices from the provincial stockpile for support during temporary periods when resources are insufficient or not available. 

Medical equipment include:

• Mechanical ventilators

• High-flow oxygen
  

• Physiological monitor

• Humidifier

• Oxygen concentrators
  

Regional hospital authorities can submit requests for assistance from the Provincial Emergency Fleet.

• Provincial Emergency Fleet request form

• or contact us for more information‎
  

Access information about the Northern Health Critical Care Recovery Program development and next steps. Please see here for the NH Communications Bulletin announcing this program.

For any questions, please reach out to CCRP@northernhealth.ca

Northern Health Critical Care Recovery Program (May 6^th Webinar)

These guidelines were developed with the collaboration of the members of a multidisciplinary team including Burns and Plastic Surgery, Trauma Services BC, Emergency Care BC, Critical Care BC, British Columbia Emergency Health Services, Provincial Health Services Authority, and Transport Medicine.

V12 has been updated (from April 2025) to reflect the following:

• Application: Adults older than 16 years of age (though the principles and techniques are the same for children, due to size and depth) we are recommending reaching out to Pediatric SMEs prior to performing the procedure.
• Abdominal incision: included an update on extending inferiorly into the abdomen for ACS.
• Escharotomy for Patients with Burns – Provincial Clinical Practice Guideline - V12

Please see Society of Critical Care Medicine guidelines for Point of Care Ultrasound use.

• Guidelines on Adult Critical Care Ultrasonography 2024 | SCCM