Chain of Survival Lesson

The chain of survival refers to a series of actions that, when put into motion, reduce the mortality associated with cardiac arrest. Like any chain, the chain of survival is only as strong as its weakest link. The four interdependent links in the chain of survival are early access, early CPR, early defibrillation, and early advanced cardiac life support.

Chain of help Image

Links in chain labeled:
Early Access
Early CPR
Early Defibrillation
Early Advanced Care

Early Access

Ideally, someone must recognize an impending cardiac arrest or otherwise witness the cardiac arrest and activate the EMS system as early as possible with an immediate call to the emergency services. Unfortunately, many persons experiencing symptoms (for example, angina) that may lead to a cardiac arrest ignore these warning symptoms or, recognizing these warning symptoms correctly, fail to activate the EMS system, preferring to contact relatives instead (the elderly often contact their adult offspring rather than contact emergency services).

Early CPR

In order to be most effective, bystander CPR should be provided immediately after collapse of the patient. Properly performed CPR can keep the heart in a shockable ventricular fibrillation for 10-12 minutes longer.

Early Defibrillation

Early defibrillation is the link in the chain most likely to improve survival. Public access to defibrillation devices such as AED's may be the key to improving survival rates in out-of-hospital cardiac arrest.

Early Advanced Care

Early advanced cardiac life support by paramedics is another critical link in the chain of survival.

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