The Chain of Survival: Giving Cardiac Arrest Patients the Best Chance of Survival

The Chain of Survival describes the essential steps that give a person in cardiac arrest the best possible chance of surviving and recovering with a good quality of life. Each link in the chain is vital, and every second counts.

If any one link is weak or delayed, the chances of survival fall dramatically. When all links are strong, outcomes improve and more people return to their families and communities.

Link 1: Early Recognition and Calling for Help

The first link focuses on recognising serious illness early and calling for help before cardiac arrest occurs.

Early warning signs may include:

• Sudden collapse
• Difficulty breathing
• Chest pain
• Rapid deterioration or reduced responsiveness

If you suspect someone is becoming seriously unwell or unresponsive, call the emergency services immediately.

Early activation of emergency medical services (EMS) ensures advanced care is on the way as soon as possible. In some cases, early intervention may even prevent cardiac arrest from happening.

Link 2: Early CPR and Defibrillation

This link is about preserving the brain and restarting the heart.

If a person becomes unresponsive and is not breathing normally, they are in cardiac arrest.

• Start CPR immediately
• High-quality chest compressions maintain blood flow to the brain and vital organs

Defibrillation is the next critical step. Early use of an AED (Automated External Defibrillator) dramatically improves survival.

Modern AEDs are safe, simple to use, and provide clear voice prompts. The sooner a shock is delivered, the greater the chance of restoring a normal heart rhythm.

Link 3: Advanced and Post-Resuscitation Care

When the heart restarts, this is known as ROSC – Return of Spontaneous Circulation. At this point, care must continue immediately.

This stage focuses on optimising brain and heart function and preventing further deterioration.

Key priorities include:

• Maintaining adequate oxygenation and ventilation
• Stabilising blood pressure
• Treating ongoing or recurrent arrhythmias
• Identifying and correcting reversible causes

This phase is critical for protecting the brain, supporting the heart, and reducing the risk of another cardiac arrest.

Link 4: Survival and Recovery

The final link focuses on restoring quality of life.

Survival is not just about restarting the heart. It is about helping the person recover physically, mentally, and emotionally.

This stage may involve:

• Specialist neurological care
• Rehabilitation and physiotherapy
• Management of long-term heart or medical conditions
• Emotional and psychological support

Good post-resuscitation care helps patients regain independence and return to a meaningful life after cardiac arrest.

Why the Chain of Survival Matters

The Chain of Survival highlights that every link matters:

1. Early Recognition and Calling for Help
2. Early CPR and Defibrillation
3. Advanced and Post-Resuscitation Care
4. Survival and Recovery

When each link is strong, more lives are saved, and more people return to their families and communities with positive long-term outcomes.