A Comprehensive Guide to the Chain of Survival

A Comprehensive Guide to the Chain of Survival

Cardiac arrest deaths are common in the US. According to the NIH, there are 300,000-450,000 cardiac arrest casualties yearly, many of which have no prior knowledge of any heart problems.

In cases like this, besides dialing 911, there are other ways to help the victim, like giving CPR. In fact, a person doesn’t have to be a medical person to save a life – they merely have to know the links of the chain of survival.

If you want to learn more about the effective cardiac arrest response, you’ve come to the right place. Our comprehensive guide to the chain of survival will explore the necessary resuscitation techniques any bystander should be aware of.

Ultimately, we will review the survival rates after cardiac arrest to help you understand the importance of CPR.

What Is the Chain of Survival?

The chain of survival refers to a set of steps a bystander or medical professional must perform to resuscitate a cardiac arrest victim. When a person follows the steps of the chain of survival, they increase the survival chances of a person in cardiac arrest.

The term “chain of survival” first appeared in 1988 in the form of a slogan for the Conference on Citizen CPR, after which it was adopted by the AHA to highlight the essential steps of cardiac care.

The chain of events or steps that have to be taken include:

      • Early recognition (calling 911)

      • Early CPR

      • Prompt defibrillation

      • Advanced cardiac care

      • Post-cardiac arrest care and possible survival to discharge.

    Below, we take a closer look at each link of the chain of survival.

    Chain of Survival: Links Explained

    As mentioned, the chain of survival is composed of several (fixed) links that have to be followed in order for a bystander and medical personnel to provide proper help to a victim:

        1. Early Identification of Cardiac Arrest

      The first link is identifying the cardiac arrest case in a victim and deciding to help them. If you’re not sure if a person is undergoing a cardiac arrest, the early signs of a cardiac arrest case include:

          • Abnormal breathing or difficulty in breathing

          • Heart palpitations and chest pain

          • Excessive fatigue

          • Back pain

          • Symptoms resembling the flu

          • Stomach ache, nausea, or vomiting

          • Dizziness or total loss of consciousness.

        As soon as you notice a person showing one or more of these symptoms, call 911 immediately, then step in to help the victim.

            1. Early CPR Focused on Chest Compressions

          As soon as you call the emergency medical services, proceed to perform CPR. The sooner you start with CPR, the better. If the bystander is untrained in CPR, they should start with chest compressions or heart massages.

          If you ever find yourself in a position of a bystander (regardless if you’ve passed a CPR course or not) there are a few critical notions you should know about if you decide to help. Namely, a person should immediately begin with heart compressions right after the victim stops breathing. The bystander should give compressions 2 inches deep and aim for 100-120 compressions a minute.

          It’s important to note that the chest has to fully recoil between compressions for effective CPR. Otherwise, the victim has to receive CPR supported by AED until the EMS team arrives to take over the case.

              1. Rapid Defibrillation

            Many states in the US have added AEDs in places where SCA is most common, such as schools, community centers, shopping malls, airports, and even private workplaces.

            If CPR doesn’t work, you should grab the nearest AED immediately and position it right next to the casualty. After that, turn it on and apply the adhesive pads to the victim’s chest. You don’t need to be an expert to use an AED – today’s devices are designed for both bystanders as well as medical personnel. AEDs in public spaces instruct the rescuer via voiced messages or notes on the screen.

            Before the electro-shock, the rescuer must ensure no one is touching the victim and that the area around the chest is dry and free of clothing or accessories. Once all security measures are established, the rescuer can proceed to give the victim an electric shock.

                1. Effective Advanced Life Support

              If a person does not show signs of life even after the electro-shocks, you will have to continue with the CPR until the EMS arrives. Usually, such cases are more complex and require care and attention from a medical professional.

              The medical person, in this case, will take over the case and try to regulate the situation by continuing with CPR and AED, implementing medication, or ultimately applying airway release procedures or other advanced life support techniques to help the victim stay alive until they reach the hospital before they reach the hospital. This usually helps the victim the most, and they might even start showing signs of life.

              After the person reaches the hospital, they will receive proper recovery treatment to help them regulate their heart rhythm and breathing. Below, we discuss the final stage of the chain of survival.

                  1. Post-cardiac Arrest Recovery

                All cases of sudden cardiac arrest are individual and require unique post-cardiac arrest recovery treatments. However, all survivors must receive physical, cognitive, and psychosocial therapy and assessment.

                The greatest danger of cardiac arrest is interrupted oxygen flow to the brain, which can sometimes result in mental or physical disabilities. Therefore, post-cardiac arrest recovery therapy is a mandatory step before a person gets dismissed from the hospital.

                Survival Rates After Cardiac Arrest Statistics

                CPR is a highly important skill to have in case of a cardiac arrest incident. If a victim undergoes sudden cardiac arrest, a rescuer reacting right on the spot can double or triple the survival rates.

                Speaking of survival rates, a study finds that sudden cardiac arrests remain the leading cause of death in the US, with 90% of victims passing away before they even get to leave the hospital. Furthermore, the in-hospital survival rate is 50%-60%. Given the results from the research, the main cause of these cases ending up fatal is the victim remaining too long without normal oxygen flow to the brain. This usually happens when the victim does not receive immediate help from bystanders.

                The US regularly takes measures to reduce the number of death cases due to cardiac arrest and encourages bystanders to react immediately after spotting a person in cardiac arrest. For example, many states in the US include CPR training in the school curriculum. Students are obliged to learn resuscitation techniques to graduate. This way, the US prepares new generations to provide CPR in hopes of reducing the number of death cases annually.

                Importance of CPR Classes in Chain of Survival

                It’s been proven that bystander CPR can significantly boost the chances of survival of a cardiac arrest victim. However, it’s also evident that many people don’t know the proper procedure when it comes to giving CPR, such as how many compressions are required in a minute or what the compression-to-ventilation ratio is.

                By enrolling in a CPR class, you can become a trained bystander, always ready to step in and take over resuscitation attempts. By doing so, you’ll significantly increase the odds of the casualty surviving the trip to the hospital without any physical or cognitive damage.

                Chain of Survival: Key Takeaway

                To conclude this comprehensive guide to the chain of survival, let’s review some of the most important points. Namely, the chain of survival refers to a fixed set of links, the first three of which must be practiced by a bystander looking to help a cardiac arrest victim.

                The term chain of survival first appeared in 1988, but once the AHA adopted it, it became a widely accepted step-by-step guide on providing first aid to a cardiac arrest casualty. The chain is made up of 5 links:

                    • Dialing 911

                    • Administering CPR

                    • Using an AED

                    • Effective advanced life support

                    • Hospital care and recovery.

                  When approaching a victim in an accident, there are tell-tale signs that point to an SCA, such as heart palpitations, interrupted breathing, dizziness, and complete loss of consciousness, among others.

                  For CPR to be effective, it’s important to make a distinction between the CPR techniques for infants, children, and adults. Finally, taking a CPR course is the best way to grasp each link of the chain of survival.