Chain of Survival
The term Chain of Survival provides a useful metaphor for the elements of the ECC (Emergency Cardiac Care) systems concept.
The 5 links in the adult Chain of Survival are:
Ideally, someone must recognize an impending cardiac arrest or otherwise witness the cardiac arrest and activate the EMS System as early as possible with an immediate call to the emergency services. Unfortunately, many persons experiencing symptoms (for example, angina) that may lead to a cardiac arrest ignore these warning symptoms or, recognize these warning symptoms correctly, fail to activate the EMS system, preferring to contact relatives instead (the elderly often contact their adult offspring rather than contact emergency services).
In order to be most effective, bystander CPR should be provided immediately after collapse of the patient. Properly performed CPR can keep the heart in a shock-able ventricular fibrillation for 10–12 minutes longer.
Most adults who can be saved from cardiac arrest are in ventricular fibrillation or pulseless ventricular tachycardia. Early defibrillation is the link in the chain most likely to improve survival. Public access defibillation may be the key to improving survival rates in out-of-hospital cardiac arrest, but is of the greatest value when the other links in the chain do not fail.
Early Advance Life Support
Early advanced cardiac life support by paramedics is another critical link in the chain of survival. In communities with survival rates > 20%, a minimum of two of the rescuers are trained to the advanced level. In some countries, EMS delivery may be performed by ambulance officers, paramedics, nurses, or doctors.
Integrated Post Care
A strong Chain of Survival can improve chances of survival and recovery for victims of heart attack, stroke and other emergencies.
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