First aid and CPR: Understanding the Five Links in the Chain of Survival

First aid and CPR: Understanding the Five Links in the Chain of Survival

The Chain of Survival is a series of actions that need to be taken to increase the chances of surviving a cardiac arrest. As of today, there are five links in the chain. While it is important for emergency responders and paramedics the links of survival, bystanders will need it as well.

Whether or not you are in a medical profession, knowing the links in the chain could help you save a life.

The Role of Bystanders

According to American Heart Association (AHA), approximately 350,000 cardiac arrests occur outside a hospital every year. Yet, only 6% out of those survive. However, a study shows that 45% of out-of-hospital cardiac arrest victims survive when they receive bystander CPR a few minutes after the attack.

Cardiac arrest is a serious heart condition that occurs when the heart malfunctions and suddenly stops beating. It is triggered by an electrical activity to the heart that causes irregular heartbeat or arrhythmia. When the heart’s pumping action fails, it cannot supply blood to the brain, lungs, and other organs.

Seconds later, the person may become unresponsive and have difficulty breathing. Death can occur within minutes of the attack if the victim does not receive first aid treatment,

The numbers are clear. The chance of surviving cardiac arrest is low because most people who suffer from an out-of-hospital setting do not get help soon enough.

Brain death will occur just six minutes after the attack. Performance of CPR can prolong the person’s life by circulating oxygenated blood throughout their body. First aid and CPR intervention buy valuable time for emergency responders to arrive within minutes.

Links in the Chain

The Chain of Survival is a five-step process used to provide treatment to sudden cardiac arrest victims.

It was first developed in 1990 by the American Heart Association after several decades spent on research. The links in the chain are designed in recognition of the high rates of out-of-hospital deaths that occur within a matter of minutes. Prompt execution of each link is critical because the chances of surviving cardiac arrest decrease 7 to 10% with each passing minute.

The five links in the Chain of Survival, according to the American Heart Association are the following:

  • Early Recognition of Cardiac Arrest and Activation of the Emergency Response System
  • Immediate High-Quality Cardiopulmonary Resuscitation (CPR)
  • Rapid Defibrillation
  • Basic and Advanced Emergency Medical Services
  • Advanced Life Support and Post-Cardiac Arrest Care

All links in the chain must be present to improve a person’s chances of surviving cardiac arrest. Let’s take a more detailed look at each link in the chain below.

Early recognition of cardiac arrest and activation of the emergency response system

It refers to the recognition of signs of cardiac arrest and the early activation of the emergency response protocol. It is absolutely essential in the event of an out-of-hospital cardiac emergency. When this happens, dial the emergency services number immediately. If the attack occurs on a job site or in a professional setting, it should trigger the internal alert system. It will improve the odds of obtaining on-site first aid assistance and equipment as soon as possible.

If you or someone is experiencing pain or discomfort in the chest, jaw, neck, or back, shortness of breath, or discomfort in other parts of the body, call emergency services. Also, do this when a person is unresponsive and is not breathing. If other bystanders are present on the scene, ask them to retrieve the nearest automated external defibrillator (AED).

Do not hesitate to call the emergency services if you suspect a cardiac arrest. It is always better to be safe than sorry.

Immediate High-Quality Cardiopulmonary Resuscitation (CPR)

The second link indicates that CPR should begin immediately after a cardiac arrest is determined. If you do not know how to perform CPR, call emergency services, and the dispatcher will talk you through the procedure while EMS is on the way. If you are trained in CPR, start by pushing hard and fast on the center of the person’s chest. Do this at a rate of 100-120 compressions per minute. The compression depth should be at least two inches for adults and at least one and a half inches for children. The chest should recoil completely in between compressions.

Anyone can perform CPR. If possible, perform CPR without interruption until emergency medical responders arrive for better results. Remember, any CPR is better than no CPR at all.

Rapid Defibrillation

Most cardiac arrest victims experience ventricular fibrillation (VF).

Ventricular Defibrillation is the abnormal and chaotic heart rhythm that prevents the heart from pumping blood. The treatment for VF is an electrical shock to clear the chaotic electrical activity or known as defibrillation. Within each minute of delay defibrillation, the chance of surviving cardiac arrest falls by approximately 7% to 10%.

As soon as you have access to an AED, place it directly next to the victim. Switch the on button and follow the visual and audio prompts from the device. If there is advice for shock, stand clear and make sure no one is in contact with the patient, then administer the shock.

Basic and Advanced Emergency Medical Services

The fourth link is the arrival of highly trained emergency medical services (EMS) or personnel to provide advanced cardiac life support (ACLS) outside the hospital.

It refers to the rapid response of EMS to the victims involve in the accident by administering medications, and offering advanced respiration procedures and interventions when necessary. This step is often dependent on the first link in the chain which is early recognition and call for emergency assistance!

Advanced Life Support and Post-Cardiac Arrest Care

The care you receive after the attack can be just as important as the care in the early stages. Proper post-cardiac care ensures that the person recovers as much function as possible after the attack. A cardiac arrest disrupts the flow of oxygenated blood to the brain and other vital organs in the body. Therefore, restoring brain function as well as physical health is are key parts of recovery.

In the days and weeks after a cardiac arrest, you will need to work with cardiologists, nurses, and physical therapists to make full recovery. These health professionals will suggest medical and lifestyle changes you need to protect your health going forward.

The survival rates for cardiac arrest are dreadfully low. But when every link in the Chain of Survival is followed, the person has a much better chance of surviving. You can do your part by learning how to perform first aid and CPR. We recommend taking a first aid training course to have the skill and confidence to step in during a medical emergency. First aid and CPR serve as a strong link in the chain.

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