Chain of Survival

Developed by the American Heart Association in 1990, the Chain of Survival has become the standard of care for cardiac victims. First responders are encouraged to follow this four-step sequence in rapid succession.



Early Access

Recognize the sudden cardiac arrest emergency and call 911. Recognizing the warning signs of sudden cardiac arrest is vital in treating it successfully. 

  • Loss of consciousness
  • Lack of pulse
  • Unresponsiveness
  • No breathing
Note, an immediate call to 911ensures that an advanced life support (ALS) response team
will get to the victim more quickly.


Early CPR

Providing CPR (Cardiopulmonary Resuscitation) compressions and breaths keeps oxygenated blood flowing through the heart and brain (the body’s most vital organs). Early CPR increases the chances of survival but it alone cannot save an SCA victim. If the responder has not been CPR certified, they may be able to receive assistance from the 911 emergency dispatcher. Dispatchers in many parts of the country are trained to coach callers through the basic steps of CPR. Remember, CPR should be started immediately!




Early Defibrillation

Defibrillation is the only way to stop sudden cardiac arrest. When SCA occurs, the heart must be restarted by an electrical shock. Outside a hospital setting, the only way to restart the heart is by using an automated external defibrillator (AED). Having one nearby or on the emergency vehicle when it arrives is vital. When an AED is used and electrodes are placed on the victim’s chest, electricity flows from the electrodes through the chest to the heart. For each minute that passes between collapse and defibrillation, SCA survival rates can decrease from seven to ten percent. Responders should use an AED as soon as possible to increase the chance of survival.

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Early Advanced Care

Advanced care, after using the AED, is given to the patient by paramedics and other highly trained medical personnel on scene and when the SCA victim is being transported to the hospital. Advanced care is necessary to help maintain a normal heart rhythm after successful defibrillation.


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