Introduction

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Treatment Guidelines

Welcome to the British Columbia Ambulance Service Treatment Guidelines. These guidelines are the resource documents that replace pre-hospital care protocols for Paramedic employees of the BCAS. They represent an innovative way of thinking about how Paramedics approach decisions to provide the best, most appropriate care for their patients. The Treatment Guidelines are not a linear step by step approach, but rather provide options within the appropriate scope of practice to allow Paramedics to address the patient’s specific needs. A pre-hospital diagnosis is provisional and based on limited information. Paramedics are authorized to deliver therapy in the field when it is best for the patient. Sometimes withholding a specific certain therapy may be in the best interest of the patient, particularly if definitive hospital care is readily accessible. The Treatment Guideline philosophy is based on the fundamental principle that patients will be transported to a hospital and treated if necessary. It also is expected that pre-hospital care occurs in a framework of medical oversight. Potentially new approaches such as the development of community Paramedics will require other support and more focussed medical review.

Treatment Guidelines Overview

A Treatment Guideline consists of 2 core documents, Medical Principles and Intervention Guidelines.

Medical Principles

The Medical Principles document provides key components of information that Paramedics should understand in consideration of their critical decision-making process. These Guiding Principles form the basis of supporting Paramedic treatment decisions and provide guidance to either reaffirm or enhance paramedic root training in emergency care. Paramedics must know and understand these key principles and apply them each and every time they provide care to a patient. The principles are not necessarily comprehensive, and they may change as we discover important concepts that require reinforcement to Paramedics in general.

Intervention Guidelines

The Intervention Guidelines describe the logical treatments that may benefit patients with these presentations. All are within the scope of practice for the given license level. The Intervention Guidelines are about options. They contain elements of treatment aimed at attaining a specific goal within the context of the patient's needs. Depending on the needs of the patient, Paramedics can choose to apply all of the elements, some of the elements or none of the elements identified leading up to and including their licensure and consequently within their scope of practice. The Intervention Guidelines are formatted to provide perspectives of care from the first responder level through to and including in-hospital case management. In this way, Paramedics are informed about potential care with respect to all levels of medical education and their role in that continuum of care.

British Columbia Emergency Health Services

Medical Programs Division Senior Medical Team

Dr. William Dick
Vice President, Medical Programs

Dr. Nick Balfour
Medical Director, Interior Region

Dr. Steve Blyth
Medical Director, Lower Mainland Region

Dr. Jim Goulding
Medical Director, Vancouver Island Region

Dr. Sandra Jenneson
Medical Director, Lower Mainland Region

Dr. John Ryan
Medical Director, Northern Region

Dr. John Tallon
Medical Director, Patient Care and Communications Program

Dr. Stephen Wheeler
Medical Director, Critical Care and Emergency Management

Dr. Philip Yoon
Medical Director, EPOS

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