Rick Little

Discharge Links and Patient Info
Palliative Care

Discharge Links and Patient Info

Island Health MyHealth for pts to lookup results
Pharmacy listing - all BC pharmacies with locations and phone/fax info. Shortlist is here.
Physician Contact Info Search (CPSBC) - find & print specialists' office info
Physicians On-Call List- who's on, till what time, check different sites/dates
Sick Note or rather the lack of need for it, in letter pdf form

Other collections of d/c info:

- BC Emergency Medicine Network

- https://www.pathwaysbc.ca/victoria-southisland

- HealthLink BC has tons of useful patient dc info

Pathways Public Community Services is like your medical office virtual social worker assistant!

Allows patients to access information on programs and services in our community as well as province wide!

Addictions, Opiods, and Pain

Addictions Community Treatment Walk In Clinic

Alcohol Use Disorder

Naltrexone quick card (pt) (provider)
Umbrella Society

Pain & Opiods

Cannabinoid Hyperemesis pt info sheet

Chronic pain toolkit and Painbc.ca
- Coaching for Health free health coaching program to gain self-management skills weekly 30-60 min sessions for up to 12 sessions over the phone.
  Brochure download digital version here.
Island Health Chronic Pain Resources
Pain Treatment Agreement sample
Prescription Review Committee Prescribing Principles
Self management program for chronic pain - free
Opiod Induced Hyperalgesia (OIH, TPR)

Suboxone home initiation
- Opiod current package

Mental Health and Social

PEDS

Anxiety FRIENDS program
CYMH Intake Clinics
The FOUNDRY (used to be Youth Clinic, walk-in counselling, mental health and substance use support, primary care, peer support and social services for young people 12-24)
Smiling Mind app
Toolbox - ER Protocols (Shared Care)

Family Smart - In the Know Family and Support

FamilySmart has started a new workshop series called Help For The Hard Times. These workshops are for South Island families and caregivers whose child or youth has been a patient in a psychiatric unit or have had repeated hospital ER visits at Victoria General or Ledger House. These will be delivered every month and are facilitated by parents with lived experience and are hosted online.
Details for 1-hour Workshops
- Session 1: How to support a safety plan at home (Part 1)
- Session 2: How to support a safety plan at home (Part 2)
- Session 3: How to take care of yourself and your family after a crisis
- Session 4: How to find the resources you need

Cost: Free
http://www.familysmart.ca/events
Family Smart Lisa Tate Parent in Residence Victoria. Sooke, Westshore

ADULT

Anxiety Plan (anxietycanada.com)
- Anxiety & Panic symptoms info sheet
- TIP Skills for crisis (alternate)
Bereavement helpline
BCALM.ca 8 wk Mindfulness based stress reduction program MSP covered (bcalm.ca)
- Referral info
- Smartphone apps
Borderline Personality info for pts and families
Depression info sheet (basic) (advanced)
Family caregiver support for burnout
"Mental Health 201" Course for high functioning local patients, needs referral.
Self-Injury / Cutting

Chief and Friends
- Assistance for Rx / Taxi / Parking for vulnerable VGH patients

Counselling
- Citizens Counselling Centre (self-referral)
- Cancer Agency Counselling patients and families 250-519-5525 (self-referral)

Neuro / Head & Neck

BPPV info and Home Epley tx
- Vestibular Physios
Concussion
- Concussion Brief (AAFP)
- Concussion Guidelines and Return to Play (parachute.ca)
- Concussion Return to Work (Adults step-wise)
- Concussion Return to School / Sport (Peds step-wise)
Fainting (Syncope)
- Counter-pressure techniques
Febrile Seizure (VIHA)
Neck Pain (VIHA)
Non-Epileptic Seizure (aka Pseudoseizure)
Subconjunctival hemorrhage
Stroke Warning Signs / Prevention

Dental

Reduced cost dental clinics (Dental Society BC)
Free Downtown Dental Clinic (Cool Aid)
Reduced Cost Dental Hygiene Student Clinic (Camosun)
After Hours Dental phone numbers to give out

Respiratory / Anaphylaxis

Home Health Monitoring (CHF, COPD followup)

Allergy & Anaphylaxis (VIHA) (AAFP)
Asthma (VIHA)
- Peds preventers vs relievers (CHEO)
- Spacer Use
Bronchiolitis
BRUE
Cough - Honey tx
Croup
Pneumothorax

CVS

Home Health Monitoring (CHF, COPD followup)

Angina
MI warning signs
Arrhythmia (incl. Afib)

Constipation
Diarrhea peds (CPS)
Diverticular dz
Gallstones
Heartburn
Hemorrhoids
Irritable Bowel IBS
- FODMAP Diet

Island Sexual Health Clinics
Kidney Stones
STI's

O&G

Abnormal Uterine Bleeding
Miscarriage
Unplanned pregnancy
Emergency Contraception Pills or alternate

- Pregnancy self-referral for GP OB care

- Menopause referrals being accepted at the WomenMD clinic

WomenMD provide menopause consults by physicians who are certified by the North American Menopause Society (NAMS). The clinic also offers an 8-week menopause educational program that incorporates mindfulness training and cognitive behavioural strategies for patients.

Referral forms can be found on Pathways.bc.ca or the clinic website www.womenmd.ca

Home Health Monitoring

Now called Community Virtual Care, Home Health Monitoring offers monitoring for patients with heart failure, COPD and diabetes across all of Island Health. Home Health Monitoring also added screening tools for anxiety, depression and chronic pain. Patients are provided with a tablet and biometric devices with which to complete a daily monitoring plan. A nurse monitors this information and provides ongoing education and coaching on self-management, as well sharing key information with the family physician.

Home Health Monitoring referrals in Greater Victoria can be made by calling the:
Physician Connectors at 250-519-5282 or faxing referrals to 250-519-5288.

Below is eligibility criteria and referral contact information: Consider referral to Home Health Monitoring if your patient:

Has a confirmed diagnosis of COPD or heart failure and is symptomatic
Has confirmed diagnosis of diabetes and is struggling to manage blood glucose
Is willing to engage in self-management

Home Health Monitoring

MSK

AC Sprain
BACK PAIN
- Choosing Wisely campaign against CT / XR (USA & CDN)
- Disc herniation (AAFP)
- Low Back Pain prevention (WCB)

Buckle # followup
Gout
Home exercises multiple MSK conditions, evidence-based (pics and video)
ReBalanceMD patient info, multiple exercises and videos
Patellofemoral Syndrome and Exercises, 2nd link
Shoulder auto-reduction for recurrent subluxation
Shoulder exercises
Strains / Sprains

Meds Lab Blood

Blood and Body Fluid Exposure
- Risk of acquisition bloodborne pathogens chart
- Pt info sheet
Higher Potassium Foods to eat
Search Tool for Drug Costs
- DrugSearch.ca -- free web tool created by a Vancouver software engineer and Pharmacist to show drug prices and if covered by the provincial government. You will also be told if the drug has Special Authority
- Or this Blue Cross one shows a map and the dispensing fees to compare
Medication Specific Pt Info Sheets

(e.g. warfarin, digoxin, lithium, insulin)

Warfarin vs DOAC / NOAC for DVT/PE comparison table (VIHA)

ENOXAPARIN

Dose rounding by PATIENT WEIGHT for 1.5 mg/kg daily
Patient Weight	Dose (1.5 mg/kg)
Less than 46 kg 	60 mg
46 – 58 kg 	80 mg
59 – 68 kg 	100 mg
69 – 85 kg 	120 mg
86 – 100 kg 	150 mg
101 – 115 kg 	160 mg (80 mg x 2)
116 – 140 kg 	200 mg (100 mg X 2)
141 – 160 kg 	240 mg (HP 120 mg / 0.8 mL x 2)
Greater than 160 kg 	1.5 mg/kg/day (use multi-dose vial*)
* DO NOT use this dosage form in pregnancy - enoxaparin multi-dose vials contain benzyl alcohol

Peds

Pediatric allergist patient resource

Radiology

X-Ray Risk calculator for various studies including CT.

Compares to

Estimated Lifetime Risk of Death from Various Sources13

Motor Vehicle Accident	1% or 1 in 100 chances
Drowning	0.1% or 1 in 1000 chances
Bicycle Accident	0.01% or 1 in 10,000 chances
Lightning	0.001% or 1 in 100,000 chances