Intermediate Life Support

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Intermediate Life Support (ILS) is a level of training undertaken in order to provide emergency medical care outside medical facilities (prehospital care). ILS is classed as mid-level emergency medical care provided by trained first responders who receive more training than basic life support providers (EMT-Basics, Basic First Responders and First-aid providers (depending on country)), but less than advanced life support providers (such as Paramedics, Nurses and Doctors). Intermediate Life Support is also known as Limited Advanced Life Support (LALS), [1] Immediate Life Support, or Intermediate Advanced Life Support (IALS). [2]

Contents

Description

ILS contains skills and protocols from advanced life support. In the US, the level of training is comparable with Emergency medical technician – intermediate (EMT-I), Emergency Medical Technician II or Advanced Emergency Medical Technicians (depending on state). Intermediate Life Support was first used in the US in 1985, and is now used around the world. [3]

ILS can be used for transporting and non-transporting EMS.

It can be run as a separate course for professionals and volunteers, or as addition to Advanced Life Support for people without training in prehospital care. [4] Because its scope of practice, ILS can be an addition at the clinical skills for doctors, medical students, nurses, nursing students, midwives, healthcare providers such as physiotherapists, dentists and ambulance technicians. It may also be suitable for fire service technicians, police personnel and prison officers. [5]

It provides the knowledge and skills to:

Improving the quality of fast first response is the main goal of intermediate life support.

Scope of practice

Intermediate life support providers are called Medicals, Advanced Medicals, EMT II, EMT-Intermediate, or Advanced Emergency Medical Technicians (depending on country and state). Mostly the Medicals and Advanced Medicals work as a Medical team. They both had the same training, but the Advanced Medical is allowed to provide the advanced medical skills. Advanced Medicals work on a daily base as nurses, anesthesiologist-assistants, medical students, paramedics, or physician assistants.

Providing a wide range of medical skills and treatment at scene allows the Medical Team to provide better medical care to their patients than regular first aid. Without the Advanced Medical at scene, the Medicals still can provide a wide range of medical care. Medicals can immobilize fractures of the extremities, stabilize the cervical spine and monitor vital signs as oxygenation (SpO2), pulse, blood pressure, glucose, and consciousness. They are also trained to administer oxygen, oral glucose, ipratropium/salbutamol inhalation, fentanyl intranasal spray, valium klysma and paracetamol oral. The scope of practice of the Intermediate Life Support trained Medicals is comparable with the EMTs known in the US. No needles are required in treatment. [6]

When an Advanced Medical is on scene, it increases the abilities to provide a wider range of emergency medical care. The Advanced life support protocols are partly integrated in the intermediate life support. Cardiac arrests [7] and anaphylactic shock treatments can be provided in the same way as Advanced Life Support and Ambulance protocols [8] subscribe. [9] That means also that bag-mask ventilation and inserting an intermediate airway device (iGel or other supraglottic airway device) can be performed if the Advanced Medical has been properly trained. [10] They also start intravenous access and administer medication in case of cardiac arrest, anaphylactic shock or hypoglycemia.

Related Research Articles

<span class="mw-page-title-main">Emergency medical services</span> Services providing acute medical care

Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. They may also be known as a first aid squad, FAST squad, emergency squad, ambulance squad, ambulance corps, life squad or by other initialisms such as EMAS or EMARS.

<span class="mw-page-title-main">Emergency medical technician</span> Health care provider of emergency medical services

An emergency medical technician is a medical professional that provides emergency medical services. EMTs are most commonly found serving on ambulances and in fire departments in the US and Canada, as full-time and some part-time departments require their firefighters to be EMT certified.

<span class="mw-page-title-main">Paramedic</span> Healthcare professional who works in emergency medical situations

A paramedic is a healthcare professional trained in the medical model, whose main role has historically been to respond to emergency calls for medical help outside of a hospital. Paramedics work as part of the emergency medical services (EMS), most often in ambulances. They also have roles in emergency medicine, primary care, transfer medicine and remote/offshore medicine. The scope of practice of a paramedic varies between countries, but generally includes autonomous decision making around the emergency care of patients.

<span class="mw-page-title-main">Certified first responder</span> Person who provides pre-hospital care for medical emergencies

A certified first responder is a person who has completed a course and received certification in providing pre-hospital care for medical emergencies. Certified individuals should have received much more instruction than someone who is trained in basic first aid and cardiopulmonary resuscitation (CPR) but they are not necessarily a substitute for more advanced emergency medical care rendered by emergency medical technicians and paramedics. First responders typically provide advanced first aid level care, CPR, and automated external defibrillator (AED) usage. The term "certified first responder" is not to be confused with "first responder", which is a generic term referring to the first medically trained responder to arrive on scene and medically trained telecommunication operators who provide pre-arrival medical instructions as trained Emergency Medical Dispatchers (EMD). Many police officers and firefighters are required to receive training as certified first responders. Advanced medical care is typically provided by EMS, although some police officers and firefighters also train to become emergency medical technicians or paramedics.

<span class="mw-page-title-main">Advanced life support</span> Life-saving protocols

Advanced Life Support (ALS) is a set of life saving protocols and skills that extend basic life support to further support the circulation and provide an open airway and adequate ventilation (breathing).

<span class="mw-page-title-main">Paramedics in Canada</span> Overview of paramedics in Canada

A paramedic is a healthcare professional, providing pre-hospital assessment and medical care to people with acute illnesses or injuries. In Canada, the title paramedic generally refers to those who work on land ambulances or air ambulances providing paramedic services. Paramedics are increasingly being utilized in hospitals, emergency rooms, clinics and community health care services by providing care in collaboration with registered nurses, registered/licensed practical nurses and registered respiratory therapists.

<span class="mw-page-title-main">Advanced trauma life support</span> American medical training program

Advanced trauma life support (ATLS) is a training program for medical providers in the management of acute trauma cases, developed by the American College of Surgeons. Similar programs exist for immediate care providers such as paramedics. The program has been adopted worldwide in over 60 countries, sometimes under the name of Early Management of Severe Trauma, especially outside North America. Its goal is to teach a simplified and standardized approach to trauma patients. Originally designed for emergency situations where only one doctor and one nurse are present, ATLS is now widely accepted as the standard of care for initial assessment and treatment in trauma centers. The premise of the ATLS program is to treat the greatest threat to life first. It also advocates that the lack of a definitive diagnosis and a detailed history should not slow the application of indicated treatment for life-threatening injury, with the most time-critical interventions performed early.

Outdoor emergency care (OEC) was first developed by the National Ski Patrol in the 1980s for certification in first aid, and other pre-hospital care and treatment for possible injuries in non-urban settings. Outdoor emergency care technicians provide care at ski resorts, wilderness settings, white-water excursions, mountain bike events, and in many other outdoor environments.

<span class="mw-page-title-main">Paramedics in the United States</span> Overview of paramedics in the United States of America

In the United States, the paramedic is a allied health professional whose primary focus is to provide advanced emergency medical care for patients who access Emergency Medical Services (EMS). This individual possesses the complex knowledge and skills necessary to provide patient care and transportation. Paramedics function as part of a comprehensive EMS response under physician medical direction. Paramedics often serve in a prehospital role, responding to Public safety answering point (9-1-1) calls in an ambulance. The paramedic serves as the initial entry point into the health care system. A standard requirement for state licensure involves successful completion of a nationally accredited Paramedic program at the certificate or associate degree level.

An wilderness emergency medical technician is an emergency medical technician that is better equipped than other licensed healthcare providers, who typically function almost exclusively in wilderness environments, to better stabilize, assess, treat, and protect patients in remote and austere environments until definitive medical care is reached. Despite the term, wilderness emergency medical technician training is available and geared not just to the emergency medical technician, but also the paramedic, prehospital registered nurse, registered nurse, physician assistant, and medical doctor. After all, without an understanding of the applicable gear, skills, and knowledge needed to best function in wilderness environments, including a fundamental understanding of the related medical issues more commonly faced, even an advanced provider may often become little more than a first responder when called upon in such an emergency. WEMT training and certification is similar in scope to wilderness advanced life support (WALS) or other courses for advanced providers such as AWLS, WUMP, WMPP, and RMAP. Unlike more conventional emergency medicine training, wilderness emergency medicine places a greater emphasis on long-term patient care in the backcountry where conventional hospital care can be many hours, even days, away to reach.

<span class="mw-page-title-main">Louisville Metro EMS</span> Life support provider based in Kentucky

Louisville Metro Emergency Medical Services is the primary provider of pre-hospital life support and emergency care within Louisville-Jefferson County, Kentucky. LMEMS is a governmental department that averages 90,000 calls for service, both emergency and non-emergency, each year.

<span class="mw-page-title-main">Emergency medical services in the United States</span>

In the United States, emergency medical services (EMS) provide out-of-hospital acute medical care and/or transport to definitive care for those in need. They are regulated at the most basic level by the National Highway Traffic Safety Administration, which sets the minimum standards that all states' EMS providers must meet, and regulated more strictly by individual state governments, which often require higher standards from the services they oversee.

<span class="mw-page-title-main">Emergency medical personnel in the United Kingdom</span> People engaged in the provision of emergency medical services

Emergency medical personnel in the United Kingdom are people engaged in the provision of emergency medical services. This includes paramedics, emergency medical technicians and emergency care assistants. 'Paramedic' is a protected title, strictly regulated by the Health and Care Professions Council, although there is tendency for the public to use this term when referring to any member of ambulance staff.

An advanced emergency medical technician is a provider of emergency medical services in the United States. A transition to this level of training from the emergency medical technician-intermediate, which have somewhat less training, began in 2013 and has been implemented by most states. AEMTs are not intended to deliver definitive medical care in most cases, but rather to augment prehospital critical care and provide rapid on-scene treatment. AEMTs are usually employed in ambulance services, working in conjunction with EMTs and paramedics; however they are also commonly found in fire departments and law enforcement agencies as non-transporting first responders. Ambulances operating at the AEMT level of care are commonplace in rural areas, and occasionally found in larger cities as part of a tiered-response system, but are overall much less common than EMT- and paramedic-level ambulances. The AEMT provides a low-cost, high-benefit option to provide advanced-level care when the paramedic level of care is not feasible. The AEMT is authorized to provide limited advanced life support, which is beyond the scope of an EMT.

Emergency Medical Technician is the entry level of Emergency Medical Technician in the United States.

In the United States, the licensing of prehospital emergency medical providers and oversight of emergency medical services are governed at the state level. Each state is free to add or subtract levels as each state sees fit. Therefore, due to differing needs and system development paths, the levels, education requirements, and scope of practice of prehospital providers varies from state to state. Even though primary management and regulation of prehospital providers is at the state level, the federal government does have a model scope of practice including minimum skills for EMRs, EMTs, Advanced EMTs and Paramedics set through the National Highway Traffic Safety Administration (NHTSA).

<span class="mw-page-title-main">Emergency medical responder</span> Person who provides out-of-hospital care in medical emergencies

Emergency medical responders are people who are specially trained to provide out-of-hospital care in medical emergencies. There are many different types of emergency medical responders, each with different levels of training, ranging from first aid and basic life support. Emergency medical responders have a very limited scope of practice and have the least amount of comprehensive education, clinical experience or clinical skills of emergency medical services (EMS) personnel. The EMR program is not intended to replace the roles of emergency medical technicians or paramedics and their wide range of specialties. Emergency medical responders typically assist in rural regions providing basic life support where pre-hospital health professionals are not available due to limited resources or infrastructure.

Emergency medical services in Sri Lanka is being established using a public/private system aimed at the provision of emergency ambulance service, including emergency care and transportation to hospitals. The Pre-Hospital Care Committee is part of the Trauma Secretariat of the Sri Lanka Ministry of Healthcare and Nutrition and was established following the 2004 tsunami. The goal of the Pre-Hospital Care Sub-Committee is “During this generation and continuing for future generations, everyone in Sri Lanka will have access to trained pre-hospital medical personnel, ambulances are available to transport the sick and injured safely to hospitals, complications from harmful or inadequate pre-hospital care is eliminated so physician and nursing personnel at hospitals are delivered patients they are able to professionally treat and rehabilitate back to society as contributing citizens.” Pre-Hospital care is an essential, core component of trauma system.

<span class="mw-page-title-main">Pre-hospital emergency medicine</span>

Pre-hospital emergency medicine, also referred to as pre-hospital care, immediate care, or emergency medical services medicine, is a medical subspecialty which focuses on caring for seriously ill or injured patients before they reach hospital, and during emergency transfer to hospital or between hospitals. It may be practised by physicians from various backgrounds such as anaesthesiology, emergency medicine, intensive care medicine and acute medicine, after they have completed initial training in their base specialty.

References

  1. "EMSA-REGS-2020-12-15" (PDF). California Emergency Medical Services Authority. Retrieved 31 August 2023.
  2. "28 Pa. Code § 1027.34. Intermediate advanced life support ambulance service". Pennsylvania Code & Bulletin. Retrieved 31 August 2023.
  3. "Stichting Socorro, Hulpverleningsteam Achterhoek - Nieuws". stichtingsocorro.nl.
  4. "ARC Advanced Life Support Level 1: Immediate Life Support". 12 November 2015. Retrieved 19 January 2017.
  5. "ILS - Immediate Life Support" . Retrieved 19 January 2017.
  6. "What's the Difference Between an EMT and a Paramedic? | UCLA CPC". Cpc.mednet.ucla.edu. 18 September 2014. Retrieved 2019-08-12.
  7. "Part 7: Adult Advanced Cardiovascular Life Support". ECC Guidelines 2015.
  8. "Data" (PDF). www.ambulancezorg.nl. Retrieved 2019-08-13.
  9. "קורס עזרה ראשונה 22 שעות".
  10. "Advances in supraglottic airway devices". EMS1.

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