The Chain of Survival: Only As Strong As the Weakest Link
Survivors of sudden cardiac arrest usually have several things in common:
- Early recognition: Someone witnessed the event, recognized the emergency and decided to help;
- Early access: Someone confirmed unresponsiveness and called 9-1-1 or the local emergency number;
- Early CPR: Someone started CPR immediately;
- Early defibrillation: Someone arrived quickly with a defibrillator to shock the heart back to a healthier rhythm;
- Early advanced care: Professional emergency medical services (EMS) personnel provided advanced life support, including airway and breathing support, medications, and in some cases, hypothermia;
- Early follow-up care: The survivor received effective follow-up care.
In other words, in the ideal situation, there is a strong community Chain of Survival. Early defibrillation has been called the critical link in the Chain of Survival because the time from collapse to defibrillation often is the key indicator of survival from sudden cardiac arrest. But the strength of the early defibrillation link depends on the strength of the the links that precede it. And the strength of these two links depends on EMS system planning and quick bystander action. Let’s take a closer look.