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Chain of Survival

OVERVIEW

  • The “chain of survival” is a conceptualisation of the interventions that contribute to a successful outcome after a cardiac arrest
  • like any chain, it is only as strong as the weakest link
  • the ultimate goal is not ROSC (return of spontaneous circulation) but to get the patient home with adequate health to enjoy a meaningful life

COMPONENTS

  • Early recognition and call for help –> to prevent cardiac arrest
  • Early CPR –> to buy time
  • Early defibrillation –> to restart the heart
  • Post resuscitation care –> to restore quality of life
Chain of survival
From the European Resuscitation Council (see reference below; click image for source).

NOTE

  • There are versions of the chain of survival that include 6 or more components, e.g.
    1. Early recognition of cardiac arrest
    2. Early access to emergency medical care
    3. Early CPR
    4. Early defibrillation
    5. Early ALS
    6. Recovery (psychological and physical)
  • With the first three links in the chain being able to be performed by lay bystanders, the second three are designated to medical practitioners
Image from the American Heart Association (click image for source).

  • Wyllie, J., Bruinenberg, J., Roehr, C., Rüdiger, M., Trevisanuto, D., & Urlesberger, B. (2015). European Resuscitation Council Guidelines for Resuscitation 2015. Resuscitation95, 249-263. doi: 10.1016/j.resuscitation.2015.07.029 [Free full text]

[cite]

CCC 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the  Clinician Educator Incubator programme, and a CICM First Part Examiner.

He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.

His one great achievement is being the father of three amazing children.

On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

Dr James Pearlman LITFL Author

ICU Advanced Trainee BMedSci [UoN], BMed [UoN], MMed(CritCare) [USyd] from a broadacre farm who found himself in a quaternary metropolitan ICU. Always trying to make medical education more interesting and appropriately targeted; pre-hospital and retrieval curious; passionate about equitable access to healthcare; looking forward to a future life in regional Australia. Student of LITFL.

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