Handbook Changelog

Entries are in reverse date order (newest changes at the top). Please e-mail handbook@bcehs.ca for additional details if a change is unclear. 

• 2024-11-28
  • Removed Practice Updates from Handbook Landing Page as these have moved to the New Intranet Practice & Learning Updates
  • What's New content will be removed after 6 months
•  2024-05-01
  • Iconography change: in response to complaints about shading and colour schemes, CliniCall consultation prompts are moving away from background colours and using icons.  A red telephone (☎️) indicates a required consultation; a thinking face (🤔) indicates a recommended consultation. This change will be rolling out slowly to guidelines as they are updated.

Clinical Practice Guidelines

• 2024-12-20 
  • E08: Pain Management **REVISED**
•  2024-11-29
  • B03: Asthma and Bronchospasm updated to align with nebule vs MDI recommendations
•  2024-11-28
  • PR12: Intraosseous cannulation updated to include PCP Adult lidocaine adminstration under direction of on-scene ACP or higher 
•  2024-11-05
  • PR09: Continuous Positive Airway Pressure updated iconographs for consultation and updated CPAP image
•  2024-10-31
  • CPG Format Change: To streamline content and improve clarity, revised CPGs will adopt a simplified format. Fundamental interventions, such as Pain Management, will be listed only under the first applicable license level, with comprehensive details accessible through the linked CPG. This updated format will be gradually implemented as each guideline is revised.
•  2024-10-31
  • H10 Burns **REVISED**
•  2024-10-30
  • E08 Pain Management removed PCP IV Acetaminophen on hold language
• 2024-10-22
  • E08 Pain Management added IN Ketamine for PCP Flight trained paramedics 
•  2024-09-19
  • Neonate Page for Age Neonatal corrections
•  2024-09-19
  • E08: Pain Management added updated pain triangle and removed old algorithm
•  2024-08-02
  • B03: Asthma and Bronchospasm edited algorithm to include epinephrine and magnesium
•  2024-06-28
  • B01: Airway Management fixed overlooked Covid-era limitation on nasal cannula flow rates
•  2024-06-25
  • D03: Vascular Access and Fluid Administration included limitations on attempts at access
• 2024-06-24
  • B03: Asthma and Bronchospasm Added Severity of Asthma image
  • B04: Croup and Epiglottitis Added Westley Croup score image
• D03: Vascular Access and Fluid Administration removed consultation language for 12-16 year olds, updated language to align with PCP education
•  2024-06-19
  • D03: Vascular Access and Fluid Administration removed consultation language for 12-16 year olds, updated language to align with PCP education
  • M06: Pediatric Cardiac Arrest added intraosseous cannulation under PCP
  • N02: Adult Cardiac Arrest update language to align with PCP education, added intraosseous cannulation under PCP
  • PR12: Intraosseous Cannulation updated age limitations for PCPs

• 2024-06-19
  • Removed public access to BC Stroke Care Tiers of Service document.  This version, published in 2017, has been deprecated by Stroke Services BC ahead of the release of new guidance.  For continuity and planning purposes, the previous version remains available for use by BCEHS paramedics in care planning (you must be logged in to access this link). 
•  2024-06-14
  • Updated PR26: Venipuncture - Ethical Decision Making with PCP IO indications
  • Updated PR12: Intraosseous Cannulation with PCP contraindications
•  2024-06-11
  • Removed material relating to glucagon from E09: Anaphylaxis missed during original editing (see changes noted 2024-05-01)

Drug Monographs

• 2024-12-17
  • Removed TALLman lettering from ketorolac
•  2024-12-16
  • Removed CCP dosing from keTORolac
  • Updated Hydoxocobalamin Drug Monograph
•  2024-12-13
  • Added KeTORolac to PCP & ACP formulary 
•  2024-11-29
  • Ipratropium updated to align with nebule vs MDI recommendations
  • Salbutamol updated to align with nebule vs MDI recommendations
•  2024-11-25
  • Ibuprofen PCP Indications updated to align with Acetaminophen
  • Acetaminophen PCP IV Acetaminophen Indications updated
  • Lidocaine PCP administration under direction of on-scene ACP or higher added
•  2024-10-30
  • Acetaminophen ACP/PCP mixing instructions clarity
•  2024-10-24
  • Acetaminophen and Ibuprofen updates 
•  2024-10-22
  • Ketamine updated for PCP IN use (restricted)
•  2024-09-19
  • Acetaminophen updated with additional IV acetaminophen information(dosing etc) 
• 2024-09-17 
  • Acetaminophen added PCP antipyresis and analgesic under pediatric 
•  2024-09-12
  • Acetaminophen drip rate typo fixed
•  2024-09-03
  • Hydrocortisone consultation requirements harmonized
•  2024-08-30
  • Acetaminophen repeat dosing strategy clarified, fixed typo
•  2024-08-02
  • Calcium chloride dosing strategy clarified
  • MORPHine monograph updated
  • Acetaminophen monograph updated
  • Ibuprofen monograph updated
•  2024-07-09
  • Ondansetron pediatric age range clarified
•  2024-06-24
  • Ketamine monograph indications updated to correct oversight

Clinical Resources

• 2024-11-07
  • Added Pain Assessment Ruler to Clinical Scores
  • Re-sort of most commonly used resources
•  2024-08-02
  • Fraser Health Alternative pathways long term care added

• 2024-06-16
  • EpiDOSE enrolment card and FAQ information updated

Clinical Pathways (Restricted)

• 2024-12-10
  • Updated KGH STEMI wording
  • Updated VCH Trauma Rural and Urban
  • Updated Vancouver Coastal & Providence Off Load Delays
  • Added Vancouver Coastal & Providence Destination Guide
  • Updated Provincial ASTaR Substance Use Referral 
•  2024-12-02
  • Added Sooke Alternate Conveyance Pathway
  • Update Island Health Sobering Centers
•  2024-08-02
  • Heat Emergencies ASTaR updated

Operational Content (Restricted)

• 2024-12-17
  • Updated Manager information for Stn 228, 229, 235, 265, 268
  • Updated UC information for Stn 219, 262, 268
•  2024-12-16
  • Updated Medic One (Stn 106) Operational Notes
  • Updated Stn 306 A/UC and 314 OCUC information
•  2024-12-11
  • Updated Queen Victoria Hospital (Revelstoke) information
  • Updated Stn 252 UC information
•  2024-12-10
  • Updated Stn 773 information
  • Updated Indigenous Cultural Advisors information
  • Updated Wreck Beach rescue response 
  • Updated Stn 410 address
•  2024-12-06
  • Updated UC information for Stn 224, 252, 334, 339, 403.
•  2024-12-04
  • Updated Eagle Ridge Hospital (ERH) information
•  2024-12-03
  • Updated Stn 674 information
  • Updated Okanagan South UC information
  • Updated Region 2 OCUC information 
  • Updated Stn 248, 342, 757 UC information
•  2024-11-29
  • Updated UC information for 404 and 406. 
•  2024-11-28
  • Updated UC information for 426
•  2024-11-27
  • Updated Station 330 information
  • Updated Stn 771 door codes
  • Moved Tofino Hospital from Island North to Island Central
  • Removed 257 Annex information
  • Updated UC information for Station 314, 315.
•  2024-11-26
  • Updated information for Station 645
•  2024-11-25
  • Updated UC information for Station 404.
  • Updated Hospital information for Terrace. Ksyen Regional Hospital
  • Updated Station 304 entry code
  • Updated Okanagan Logistics Supervisor contact information
•  2024-11-21
  • Updated Manager information for Station 107, 109, 140.
•  2024-11-19
  • Updated UC information for Station 124.
•  2024-11-15
  • Updated UC information for Station 409.
•  2024-11-07
  • Updated Manager information for Station 317, 326, 328, 330, 403, 405, 406, 410, 411, 414, 415, 428.
  • Updated UC information for Station 330.
  • Updated Manager information for Station 679, 753, 763, 765, 767, 769, 773.
•  2024-11-06
  • Updated Provinical Logisitcs information
•  2024-11-05
  • Hallmark Ford updated access information
•  2024-11-04
  • Updated UC information for Station 233.
  • Updated Station 153 information
  • Updated Manager information for Station 103, 104, 105, 106, 114, 117.
  • Updated Manager information for Station 107, 109, 140.
• 2024-11-01
  • Logistics Operations Tab added under Operations with Provincial Logistics contact and address information
  • Lower Mainland Service Centers information updated. 
•  2024-10-30
  • Updated door codes Stn 761
  • Updated UC information for Station 173.
•  2024-10-28
  • Updated Station phone number for Station 107.
•  2024-10-25
  • Updated Manager information for Station 219, 222, 224.
  • Updated Vanderhoof (St.John) Hospital information
•  2024-10-24
  • Updated PPEd contact information 
  • Updated 324 door code information
  • Updated 645 UC infomation
  • Updated UC information for Station 283.
  • Updated Director information for Station 180, 280, 283, 370, 380, 580.
  • Updated Manager information for Station 370, 380, 580.
•  2024-10-22
  • Updated UC/OCUC contact information for Station 204, 315, 334.
•  2024-10-21
  • Updated Manager information for Station 225, 233, 255, 256.
•  2024-10-21
  • Updated UC information for Station 267.
•  2024-10-18
  • Updated morgue door code for Station 104.
•  2024-10-15
  • Updated Station information for 308, 318, 319, 324.
•  2024-10-09
  • Updated UC information for Station 324.
•  2024-10-07
  • Updated Manager contact information for station 228, 229, 235, 265, 268.
•  2024-10-04
  • Updated Regional PPL Contact Information
  • Updated station information for 227, 240 and 247.
•  2024-10-01
  • Vancouver General Hospital ER door code updated
•  2024-09-27
  • Updated station information for 228, 229, 235, 244, 250, 265, 268, 269, 270.
•  2024-09-24
  • Added Vancouver Island Dispatch Numbers
•  2024-09-23
  • Updated Station information for 402, 406, 410, 412, 415, 417, 419, 421, 422, 423, 424, 426, 427, 431, 532 and 767. 
  • Updated Mackenzie Hospital information
•  2024-09-12
  • Updated Station 263 information
• 2024-08-30
  • Updated LDR phone for Lion's Gate Hospital 
  • Updated contact information for Stations 243, 244, 245, 248, 250, 262, 269, 277, 326, 328, 405, 415, 417
  • Removed Pandora Avenue response restrictions
  • Updated Mt. St. Joseph Hospital access
•  2024-08-02
  • Vernon Door Code updated
  • Vancouver Sierra call signs updated

• 2024-06-26
  • Update Vancouver General Hospital page to reflect pediatric exception for VCH Acute Pediatric Sexual Abuse Pathway
•  2024-06-14
  • Update station 405 contact information
  • Update station 248 UC contact information
  • Update Fraser Health immediate release protocol