The Chain of Survival is a series of basic life support steps that, when followed promptly, give a patient the best chance of surviving an out of home cardiac arrest. Bystanders can help save lives when they act on the first three links in the chain. Each of these can be performed by anyone and should be. Every minute matters when treating cardiac arrest and as the Australian Resuscitation Council advises: any attempt at resuscitation is better than no attempt.
Early Recognition – to get help
Prompt recognition of cardiac arrest is key. If someone is not responsive and not breathing normally, immediately call emergency services (000) and get an AED. An early call for help gives the next two links the greatest opportunity for success, because the sooner the ambulance arrives, the sooner advanced care can begin.
Early CPR – to buy time
Start delivering cardiopulmonary resuscitation as soon as possible. Cardiopulmonary resuscitation (CPR) is a combination of chest compressions and airway ventilation. Use a ratio of 30 compressions to two breaths or compression only. Chest compressions help oxygenated blood flow to the person’s brain and heart until an AED can be used to attempt to restore normal heart pumping or advanced medical personnel arrive.
Early defibrillation – to restart heart
Attach an AED as soon as possible and follow the prompts. It is universally recognised that early defibrillation significantly improves survival rates. Survival can be significantly improved even 6-10 minutes after arrest, as long as effective CPR has been started early in the arrest. It is thought that good CPR may even increase the likelihood of defibrillation success. However CPR alone is not enough – only defibrillation can shock a heart back into a normal rhythm.
Early advanced care – to stabilise
The fourth link in the Chain of Survival is advanced care. Paramedics and other highly trained EMS personnel provide this advanced life support, which can include basic life support, defibrillation, administration of cardiac drugs, and the insertion of endotracheal breathing tubes (intubation). They can help maintain a normal heart rhythm after successful defibrillation and monitor the patient on the way to the hospital.
Knowing the chain means you know how to help someone survive sudden cardiac arrest, but chains are only as good as their weakest link. Don’t make a lack of AEDs your weak link.