What are the Five Links in the Chain of Survival?

The American Heart Association (AHA) Chain of Survival describes the critical actions required to treat victims of cardiac arrest. When all links of the Chain of Survival are completed this provides the best possible chance of survival from a cardiac arrest.

Let’s look at the five links in more detail:

  1. Early access to the emergency response system to ensure that additional rescuers and those capable of providing advanced life support arrive as quickly as possible.
  2. Early CPR to support circulation to the heart and brain until normal heart activity is restored.
  3. Early defibrillation can help terminate an abnormal rhythm and restore a regular heart rhythm.
  4. Early advanced care will be provided by EMS and hospital personnel with additional training and expertise.
  5. Integrated post-cardiac care to improve survival for victims of cardiac arrest who are admitted to a hospital after resuscitation

The first link in the treatment of any emergency is to recognize that an emergency exists and phoning the appropriate emergency response number.

The second link is early cardiopulmonary resuscitation (CPR) – delivery of chest compressions and rescue breaths to a victim who is not breathing normally. CPR is the critical link that buys time between the first link (early access) and the third link (early defibrillation). CPR Supports the delivery of oxygen to the brain and heart until defibrillation or other advanced care can restore normal heart action.

The third link is early defibrillation – this is because most adult victims of a witnessed sudden cardiac arrest are in ventricular fibrillation (VF). VF is an abnormal and chaotic heart rhythm that prevents the heart from pumping blood. The treatment for VF is an electrical shock to clear the chaotic electrical activity, this is known as defibrillation. With each minute that defibrillation is delayed, the victim’s chance of survival falls by approximately 7% to 10%.

The fourth link is the arrival of highly trained EMS personnel to provide advanced cardiac life support (ACLS) outside the hospital.

The fifth link is the integrated in-hospital care management that a person will receive if the victim is resuscitated.

John Furst

JOHN FURST is an experienced emergency medical technician and qualified first aid and CPR instructor. John is passionate about first aid and believes everyone should have the skills and confidence to take action in an emergency situation.

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