Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Chain of survival
Introduction
Overview
Overview
The chain of survival refers to a series of actions that, when put into motion, reduce the mortality associated with cardiac arrest.[1][2] Like any chain, the chain of survival is only as strong as its weakest link.[1][2] The four interdependent links in the chain of survival are early access, early CPR, early defibrillation, and early advanced care.[1]
Etymology
Etymology
The phrase “chain of survival” was first used as a slogan for the 1988 Conference on Citizen CPR.[3][4] It then appeared in JEMS editorial in August 1989, and the first issue of Currents in Emergency Cardiac Care in 1990.[3] The concept was elaborated in the American Heart Association’s 1992 guidelines for cardiopulmonary resuscitation and emergency cardiac care,[5][6] and then echoed by the International Liaison Committee on Resuscitation (ILCOR) in 1997.[1]
Early access
Early access
Someone must witness the cardiac arrest and activate the EMS system[1] with an immediate call to 9-1-1[7] (or your local emergency number).
Early CPR
Early CPR
In order to be most effective, bystander CPR should be provided immediately after collapse of the patient.[1][8] Properly performed CPR can keep the heart in VF for 10-12 minutes longer.[2]
Early defibrillation
Early defibrillation
Most adults who can be saved from cardiac arrest are in ventricular fibrillation or pulseless ventricular tachycardia.[9] Early defibrillation is the link in the chain most likely to improve survival.[1] Public access defibillation may be the key to improving survival rates in out-of-hospital cardiac arrest,[1] but is of the greatest value when the other links in the chain do not fail.[2]
Early advanced care
Early advanced care
Early advanced cardiac life support by paramedics is another critical link in the chain of survival.[1] In communities with survival rates > 20%, a minimum of two of the rescuers are trained to the advanced level.[1] In some countries, EMS delivery may be performed by ambulancemen, nurses, or doctors.[2]
References
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 “Part 12: From Science to Survival – Strengthening the Chain of Survival in Every Community,” Circulation 2000;102:I-358
- ↑ 2.0 2.1 2.2 2.3 2.4 Bossaert LL (1997). “Fibrillation and defibrillation of the heart”. British journal of anaesthesia. 79 (2): 203–13. PMID 9349131.
- ↑ 3.0 3.1 “The Addition of the Fifth Link in the Chain of Survival to Include Myocardial Infarction,” ChestPainCenters.org, Accessed July 11, 2007.
- ↑ “Chain of Survival: Converting a Nation,” Citizen CPR Foundation, Accessed July 11, 2007.
- ↑ Cummins RO, Ornato JP, Thies WH, Pepe PE (1991). “Improving survival from sudden cardiac arrest: the “chain of survival” concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association”. Circulation. 83 (5): 1832–47. PMID 2022039.
- ↑ “Guidelines for cardiopulmonary resuscitation and emergency cardiac care. Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Part I. Introduction”. JAMA. 268 (16): 2171–83. 1992. PMID 1404767.
- ↑ “Strengthening Each Link in the Chain of Survival,” American Heart Association, Accessed July 10, 2007.
- ↑ Eisenberg MS, Bergner L, Hallstrom A (1979). “Cardiac resuscitation in the community. Importance of rapid provision and implications for program planning”. JAMA. 241 (18): 1905–7. PMID 430772.
- ↑ “Early Defibrillation,” Circulation 1997;95:2183-2184.
External links
External links
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]