The first 48-hours

Feb 14, 2019 | News

Last week we had asked the question, what would happen if we took the walls off the ICU?

Turns out, pretty great things!

The Critical Care Outreach Team (CCOT) launched at St. Paul's on February 11, and within the first 48-hours the team had supported 28 patient visits, averaging 45 minutes per visit.

The team for those first 48-hours was made up of:

  • Registered Nurses (RN): Mindy, Lynne, and Annie
  • Registered Respiratory Therapists (RRT): Russ, Dalvir and Sean
  • Physicians: Dr Ayas with his resident Dr Simon Hasan

Caption (l to r): Mindy, Dalvir, and Lynne on their inaugural CCOT shift!

Great work, everyone! 

So, why a call the CCOT?

“Early intervention is key,” says ICU CNE Mia Marles. “Successful outreach teams depend on the ward team to call early, and call often. You don't have to be able to put a finger on “the why” – just that you have a feeling that something isn’t right with your patient is enough of a reason to pick up the phone and call us.”

Early Warning Signs:

  • Threatened airway
  • Oxygen saturation less than (<) 90% and/or increasing oxygen needs
  • Respiratory rate less than (<) 10 or greater than (>) 30 breaths/minute
  • Systolic blood pressure less than (<) 90 or greater than (>) 210 mmHg
  • Heart rate less than (<) 40 or greater than (>) 140 beats/minute
  • Sudden change/decrease in LOC
  • Urine output less than (<) 100 mL over the past 4 hours
  • Elevated MEWS score
  • Clinician / caregiver concern - being worried is reason enough.

The most important factor to the success of the CCOT service is the patient’s primary care team.  

“They are the fourth member of the CCOT team, because they are the eyes and ears. We won’t succeed in saving patients’ lives without attentive, proactive hospital staff to call CCOT early so we all can make that difference,” says Critical Care Outreach Team (CCOT) lead and Critical Care CNS Vininder (Vini) Bains. 

CCOT Cole’s Notes:

  • The CCOT is a dedicated, 24/7 service that makes specialized critical care a phone call away.
  • The aim is to respond to all calls within 5 minutes: 604-319-3536.
  • Being worried is reason enough. Call early, call often.

Caption: The CCOT Team, ready to leap into action to help support your patient whenever necessary!

Additional information

  • Look for posters on your unit for the details on early signs and the number to call, as well as phone stickers and lanyard cards, which will be distributed to ward staff for quick reference.
  • Posters will also be posted through St. Paul’s for general awareness of the CCOT.
  • If you would like an in-person overview of the CCOT, how it works and how the team can work collaboratively with your unit, please email
  • Head to the ICU website and read up on the CCOT:

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