The immediate life support course
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].
Section snippets
Course structure
The ILS course is delivered over 1 day and comprises lectures, hands on skill stations, and simulated cardiac arrest scenario teaching (CASTeach) using manikins. The programme includes several options to enable course centres to tailor the teaching to the requirements of their candidates (Fig. 1). For example, operating department practitioners (ODPs) are taught airway skills during their general training and may benefit more from the optional drugs tutorial (Fig. 2).
Administration
In an attempt to control quality, at present the ILS course is available only to accredited RC (UK) course centres. These centres are monitored by the RC (UK) as part of the quality control strategy that accompanies the ALS course. However, in comparison with the ALS course, centres have far more autonomy in running the ILS course. Course centres register to run the course by paying an annual registration fee. By registering they agree to run the course in accordance with the regulations. The
Recertification
ILS certification is valid for 1 year. Revalidation can be achieved by repeating the whole course or by undertaking a half-day recertification course.
First year's results
Data from the first year (January 1st to December 31st 2002) of the ILS course is summarised in Table 3. The results are based on all returns to the RC (UK) up to 7th January 2003. There were 1800 ILS courses in 128 course centres with a total of 16 547 candidates. A wide range of health care professionals have attended the course with hospital nurses by far the biggest group. The failure rate is extremely low (0.92%) and implies that the knowledge and skills taught on the course are attainable
Integration
The ILS course introduces the concept of recognising the acutely ill patient and intervening in order to avert a cardiac arrest from occurring. The 1-day multi-professional ALERT™ course further develops these important skills in small group scenario based discussion and skill stations [11]. The combination of the ILS and ALERT™ courses provides a complimentary package of training for the early management of the acutely ill patient and the patient in cardiorespiratory arrest. These courses
Future developments
After a successful first year, there is considerable interest in the ILS course from non RC (UK) accredited centres in the UK and from other European countries. The ILS course working group is exploring ways to expand the number of course centres to meet the demand, while simultaneously developing a strategy to maintain a consistent standard for ILS teaching and certification.
Conclusions
The ILS course has had a successful first year with 16 547 candidates attending the course in 2002. The challenge now is opening up the course to more centres whilst maintaining the quality of teaching. It is hoped that this course may also become established in continental European countries through the ERC in future.
Acknowledgements
We are grateful to all the individuals at course centres throughout the UK who have helped in establishing the ILS course.
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Cited by (54)
Update on in hospital resuscitation
2016, Medicina ClinicaPrognostic factors for in-hospital cardiopulmonary arrests. A review of 760 cases
2016, Medicina ClinicaEuropean Resuscitation Council Guidelines for Resuscitation 2015. Section 3. Adult advanced life support.
2015, ResuscitationCitation Excerpt :The introduction of specific, objective calling criteria,41 referral tools42 and feedback to caregivers43 has resulted in improved MET use and a significant reduction in cardiac arrests. Another study found that the number of cardiac arrest calls decreased while pre-arrest calls increased after implementing a standardised educational programme44 in two hospitals45; this was associated with a decrease in CA incidence and improved CA survival. Other research suggests that multi-professional education did not alter the rate of mortality or staff awareness of patients at risk on general wards.46
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ILS working group members, Jerry Nolan, Maggie Briggs, Ian Bullock, Pauline Clark, David Gabbott, Sara Harris, Sarah Mitchell, Gavin Perkins, Alex Scott, Gary Smith, Jasmeet Soar, Paul White, Karla Wright.