The mission of the CCCS is to promote and enhance Critical Care Medicine in Canada.

PREAMBLE

Seasonal influenza remains a significant threat to the health of Canadians. H1N1 represents a high level threat to health care resources. In particular intensive care units have experienced significant increases (surges) in patients who require intubation and mechanical ventilation for severe influenza like infection (ILI). Conservative estimates project an attack rate of 30% and that of those infected 0.2% of cases will be severe. Therefore in a population the size of greater Montreal (3.6 million using 2006 statistics) this would translate into 2,160 critically ill patients.

Based on these resource concerns the Canadian Critical Care Society has developed recommendations for practitioners and policy makers to assist them in preparing for H1N1. These recommendations were initially developed at a meeting on Severe H1N1 that was sponsored by the Canadian Public Health Agency in Winnipeg on September 2 and 3 in Winnipeg, Manitoba. It is important to emphasize that owing to limitations in data and published reports these recommendations are based primarily on expert opinion and fall short of the rigor usually demanded for guideline development. Furthermore these recommendations have not been endorsed by the Canadian Public Health Agency. Despite limited data however, we felt it important that recommendations that considered the needs of Canadians and our health system be brought forth assist with pandemic planning. The recommendations that follow have been adapted from those provided from other organizations and consensus of the CCCS H1N1 working group (see appendix). Where possible we have provided links to organizations and tools that may assist the interested reader in obtaining more detailed information and useful tools and resources.