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The Chain of Survival
In 1990, the American Heart Association developed the Chain
of Survival. This protocol addresses the fact that most SCA
episodes occur outside of a hospital, with death occurring
within minutes of onset. For the Chain to be effective, quick
execution of each and every link is critical. With each minute
that passes, the likelihood of survival decreases 7-10%.
| Time After the Onset of Attack |
Survival Chances |
| With every minute |
Chances are reduced by 7-10% |
| Within 4-6 minutes |
Brain damage and permanent death start to occur |
| After 10 minutes |
Few attempts at resuscitation succeed |
To provide the best opportunity for survival, each of these
four links must be put into motion within the first few minutes
of SCA onset:
- Early Access to Emergency Care must be provided
by calling 999.
- Early CPR should be started and maintained until emergency
medical services (EMS) arrive. This buys time until an
AED can be applied.
- Early Defibrillation is the only procedure that
can re-start the heart function of a person with ventricular
fibrillation (VF). If an automated external defibrillator
(AED) is available, a trained operator should administer
defibrillation as quickly as possible until EMS personnel
arrive.
- Early Advanced Care, the final link, can then
be administered as needed by EMS personnel.
ILCOR (The International Liaison Committee on Resuscitation)
and
ERC (European Resuscitation Council), both maintain
that the highest potential survival rate from cardiac arrest
can be achieved only when all elements of the chain of survival
are combined.
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