Intermediate life support for adults

• Improve understanding of Intermediate Life Support (ILS) in the adult patient, including the early recognition of deterioration
• Recognise the role of airway management and ventilation within the ILS process
• Understand defibrillation in the context of ILS, when and how it is performed

Intermediate life support (ILS) refers to a range of skills that are used to treat adult patients during cardiopulmonary arrest until experienced assistance arrives (Resuscitation Council UK, 2016). Although these skills are predominantly used in the acute hospital environment, they may also be used in other clinical settings, depending on the availability of equipment such as defibrillators. ILS includes effective basic life support (BLS) (see article: Basic life support). This article will focus on the ILS skills of early recognition of deterioration, airway management and defibrillation.

Early recognition of deterioration

Up to 80% of patients suffering cardiac arrest display evidence of deterioration in the hours before arrest; once a cardiac arrest occurs, even in the hospital environment, fewer than 20% of patients will survive until discharge (Resuscitation Council UK, 2016). Early recognition of deterioration and a call for help therefore form the first link of the Chain of Survival (Nolan et

References

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Resuscitation Council UK. The ABCDE approach. In: Resuscitation guidelines 2015. 2015. https://www.resus.org.uk/library/abcde-approach (accessed 13 December 2022) 

Resuscitation Council UK. Intermediate life support. (4th edn). London: Resuscitation Council (UK); 2016 

Resuscitation Council UK, British Heart Foundation. A guide to automated external defibrillators. 2019. https://www.resus.org.uk/sites/default/files/2020-03/AED_Guide_2019-12-04.pdf (accessed 13 December 2022) 

Royal College of Physicians. National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS. Updated report of a working party. London: