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. 

Clinical Practice Guidelines

• 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)
•  2024-05-23
  • A14: Clinical Ethics for Out-of-Hospital Providers updated link to PHSA POD 
• 2024-05-03
  • PR12: Intraosseous Cannulation clarified license level roles and restrictions
  • B03: Asthma and Bronchospasm new clarifications for disease severity; new algorithm
• 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.
  • E01: Hypoglycemia and Hyperglycemia updated to include intranasal glucagon
  • E09: Anaphylaxis removed glucagon from treatment options
  • J07: Beta Blocker Toxicity removed glucagon from treatment options
  • J09: Calcium Channel Block Toxicity: removed glucagon from treatment options
  • N02: Adult Cardiac Arrest updated intraosseous information
  • D03: Vascular Access and Fluid Administration updated intraosseous information
  • PR12: Intraosseous Cannulation updated indications

Drug Monographs

• 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
•  2024-05-17
  • Epinephrine monograph updated to include PCP anaphylaxis
• 2024-05-01 
  • Glucagon monograph updated to include intranasal administration. ACP indications changed (see associated changes to guidelines, 2024-05-01 for details). 

Clinical 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)

• 2024-08-02
  • Heat Emergencies ASTaR updated

Operational Content (Restricted)

• 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
•  2024-10-04
  • 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 Mackenzie Hospital information
•  2024-09-23
  • Updated Station information for 402, 406, 410, 412, 415, 417, 419, 421, 422, 423, 424, 426, 427, 431, 532 and 767. 
•  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
•  2024-08-02
  • 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
•  2024-05-30
  • Lions gate ER door code change
• 2024-05-24
  • Station 117 UC phone number change
• 2024-05-24
  • Station 227 Door Code Change
• 2024-05-24
  • Added L&D phone number to Lions Gate Hospital 
• 2024-05-17
  • Removed free parking location from 256 that is no longer free parking

• 2024-05-17
  • Update Crew Support & Dispatch Supervisors- VDOC contact numbers

• 2024-05-17
  • Update station 150 A/UC contact info
•  2024-05-15
  • Cariboo Memorial Hospital Triage phone number
•  2024-05-13
  • KDOC manager and team leader details
  • Victoria 118 access and location information
  • Clinton 308 contact information
•  2024-05-09
  • Atlin 751 access information
•  2024-05-01
  • Vanderhoof 771 access information