CHAIN OF SURVIVAL

The events listed below are known as the Chain of Survival and when put together in sequence they increase the chances of survival for a heart attack victim. With each minute that passes, the likelihood of survival decreases 7 - 10%

To provide the best opportunity for survival, each of these four links must be put into motion within the first few minutes.

• Early Access to Emergency Care must be provided by calling 999
• Early CPR should be started and maintained until emergency medical services arrive
• Early Defibrillation if an automated external defibrillator (AED) is available, a trained operator (such as a LIVES Responder) should administer defibrillation as quickly as possible until an ambulance arrives.
• Early Advanced Care the final link provided by ambulance paramedics or a highly trained medical personal.

The First Link in the Chain of Survival is the emergency care call.

When a Sudden Cardiac Arrest (SCA) happens an immediate 999 call is crucial; a delay of just a few minutes could prove fatal. By quickly recognising a medical emergency, a bystander can help save a life.

Could you recognise the systems of SCA?

• Unresponsiveness
• Cyanosis (blueness of lips, ears)
• Lack of Pulse
• Breathing Stopped

Early CPR

Cardiopulmonary resuscitation (CPR) is the second link in the Chain of Survival; it is the link that can buy life-saving time between the first link (Early Access to Emergency Care) and the third link (Early Defibrillation).

During SCA, the heart twitches irregularly most often due to ventricular fibrillation (VF) and cannot pump oxygenated blood efficiently to the brain, lungs, and other organs. The victim quickly stops breathing and loses consciousness.

However, prompt CPR can help sustain life during VF. The mouth to mouth breathing and chest compressions help oxygenated blood flow to the person's brain and heart, until defibrillation can attempt to restore normal heart pumping.

Although CPR can sustain life for a short time, it must be followed within minutes by the third link, early defibrillation.

Early Defibrillation

Although its important in the Chain of Survival, CPR alone cannot fully resuscitate a person in SCA. Early defibrillation is the third and perhaps most significant link. Most SCA victims are in ventricular fibrillation (VF), an electrical malfunction of the heart that causes the heart to twitch irregularly. Defibrillation, the delivery of an electrical shock to the heart muscle, can restore normal heart function if it occurs within minutes of SCA onset.

Early Advanced Care

The fourth link in the Chain of Survival is advanced care. Paramedics and other highly trained EMS personnel provide this care, which can include basic life support, defibrillation, administration of cardiac drugs, and the insertion of endotracheal breathing tubes.