The immediate life support course

Abstract

The immediate life support course (ILS) was launched by the Resuscitation Council (UK) in January 2002. This multi-professional 1-day resuscitation course teaches the essential knowledge and skills required to manage a patient in cardiac arrest for the short time before the arrival of a cardiac arrest team or other experienced medical assistance. The ILS course also introduces healthcare professionals to the role of a cardiac arrest team member. The course provides the candidate with the knowledge and skills to recognise and treat the acutely ill patient before cardiac arrest, to manage the airway with basic techniques, and to provide rapid, safe defibrillation using either manual or automated external defibrillators (AEDs). The course includes lectures, skill stations and cardiac arrest scenarios. The ILS course has standardised much of the life support training that already takes place in UK hospitals. In 2002, 16 547 candidates attended ILS courses in 128 course centres. In this article, we discuss the rationale for, and the development and structure of the ILS course. We also present the first year's results and discuss possible future developments. It is hoped that this course may become established in counties in continental Europe through the European Resuscitation Council.

Sumàrio

O Curso de Suporte Imediato de Vida (CSIV) foi realizado pela primeira vez no Reino Unido em Janeiro de 2002. É um curso multidisciplinar, com a duração de um dia, que pretende ensinar em termos teóricos e práticos como se faz a abordagem do doente em paragem cardiorespiratória (PCR), no curto intervalo de tempo que decorre até chegar a equipa de Suporte Avançado. Neste curso também se introduz o tema do trabalho em equipa. O curso proporciona a informação adequada para a abordagem inicial do doente gravemente doente, antes da PCR, para abordagem básica da via aérea e desfibrilhar com eficácia e segurança (manual ou automática externa). O Curso inclui palestras, bancas de competência e cenários de PCR. Este curso veio normalizar grande parte da formação que já era feita nesta área no Reino Unido. Em 2002 foram formados 16 547 elementos em 128 centros de formação. Neste artigo discutimos a necessidade do curso, o desenvolvimento e a estrutura do curso. Esperamos que este curso seja divulgado e estabelecido noutros paı́ses europeus através do ERC.

Resumen

El curso de soporte vital inmediato (ILS) fue lanzado por el Consejo de Resucitación del Reino Unido en Enero 2002. Este curso multiprofesional de resucitación de un dı́a de duración enseña el conocimiento esencial y las destrezas requeridas para manejar un paciente en paro cardı́aco por un perı́odo corto antes de la llegada del equipo de paro cardı́aco u otra asistencia médica con experiencia. El curso de ILS también introduce a los profesionales de salud al rol de miembro de equipo de paro cardı́aco. Este curso entrega a los candidatos el conocimiento y las destrezas necesarias para reconocer y tratar a un paciente gravemente enfermo antes del paro cardı́aco, a manejar la vı́a aérea con técnicas básicas, y a proporcionar una desfibrilación rápida y segura usando desfibriladores manuales o automáticos externos (AEDs). El curso incluye conferencias, estaciones de destrezas y escenarios de pareo cardı́aco. El curso ILS ha estandarizado mucho del entrenamiento de soporte vital que es llevado acabo este momento en los hospitales del Reino Unido. En 2002, 16547 candidatos asistieron a cursos en 128 centros de cursos. En este artı́culo, discutimos las razones para, y el desarrollo y estructura de el curso ILS. Presentamos además los resultados del primer año y discutimos posibles desarrollos futuros. Se espera que este curso pueda ser establecido en paı́ses en Europa continental a través del Consejo Europeo de Resucitación.

Introduction

Life support courses are an important source of training in the care of the acutely ill patient and the patient in cardiorespiratory arrest. The advanced life support (ALS) provider course was developed 10 years ago [1], [2]. This 2 or 3 day course is intended primarily for those healthcare professionals who attend cardiac arrests frequently or act as cardiac arrest team leaders. The comprehensive curriculum of the ALS course makes it inappropriate for the majority of healthcare professionals who attend cardiac arrests rarely but have the potential to be called upon as a first responder [3]. It is difficult to justify the provision of a 2–3 day ALS course for healthcare professionals who would not expect to put these skills and comprehensive knowledge to use—it is a waste of both their time and that of the instructors. By removing superfluous course content and focussing the training to reflect the needs of these first or occasional responders, they are more likely to acquire and retain essential knowledge and skills. This will also minimise the time that learners and instructors are taken away from clinical duties.

Many hospitals in the UK run their own ‘in-house’ short resuscitation courses tailored for hospital staff that undertake resuscitation but do not need to be trained to an ALS level. The immediate life support (ILS) course was developed to standardise much of the training that was already undertaken in UK hospitals. The ILS course trains healthcare professionals in the causes and prevention of cardiac arrest, basic life support (BLS), simple airway management and safe defibrillation [manual and/or automated external defibrillator (AED)]. These are the skills that are most likely to improve outcome from in hospital cardiac arrest [4], [5], [6]. The course enables first responders to manage patients in cardiac arrest until arrival of a cardiac arrest team and to then participate as members of that team. Table 1 lists potential candidates for the ILS course.

The ILS course was initiated by the Resuscitation Council (UK) in January 2002. This was preceded by a 2-year pilot period at several existing ALS course centres in the UK encompassing candidates from a wide variety of clinical backgrounds. During this time, the course structure, materials and methodology to administrate the course were developed by a working group. All training on the ILS course is based on current resuscitation guidelines [7].