CCBC Levels of Care - Adult Critical Care

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

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

CCBC Respiratory Clinical Resource Links

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

CHBC Pediatric CC Resources

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

Provincial Pediatric Support Pathways

ECLS resources

• Provincial ECLS transport standard workflow
• Provincial ECMO transport process checklist
  

Provincial Emergency Fleet

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
  

Sepsis

Critical Care BC and its partners works with critical care professionals across BC to develop a broad range of clinical practice guidelines that support evidence-based leading practices across the province:

• Provincial Clinical Practice Guideline Veno-Venous Extracorporeal Life Support in Acute Respiratory Failure
  

• Provincial Pediatric Sepsis Guideline & Toolkit for Emergency and Urgent Care Centres (Child Health BC)
  
• Emergency Department Sepsis Guidelines 2022 (Health Quality BC)

Notice

Influenza-related deaths associated with secondary bacterial infection among children aged 5-9 years were reported to the BCCDC. Increasing influenza activity (bccdc.ca)

While death is rare, secondary bacterial infections such as streptococcal infections, can result in rapid clinical deterioration and are important contributors to influenza-associated morbidity and mortality.

Influenza activity in BC has been increasing since November and is currently at the highest levels since the start of this respiratory season, predominated by influenza A (H1N1). Elevated influenza activity is expected to continue and there has been a reported rise in invasive group A streptococcal infections in children observed in BC, which underscores the importance of clinical vigilance, prevention and monitoring efforts for influenza, particularly among children at higher risk of severe outcomes.

What clinicians can do

Recognize Sepsis: BC Provincial Pediatric Sepsis guideline and toolkit

Secondary bacterial infections such as streptococcal infections, can result in rapid deterioration and are important contributors to influenza-associated morbidity and mortality. Early recognition of sepsis is critical. The BC Provincial Pediatric Sepsis toolkit is available on the Child Health BC website: CHBC (childhealthbc.ca)