The Chain of Survival

The best way to increase the chance of saving sudden cardiac arrest casualties is to remember and follow every link in the chain of survival:



  1. Early Access to the emergency response system;
  2. Early C.P.R. to support circulation to the heart and brain until normal heart activity is restored;
  3. Early defibrillation to treat cardiac arrest caused by ventricular fibrillation (VT); and
  4. Early advance care by paramedics and hospital personnel

The first link, early access, includes early recognition of the cardiac emergency and early notification of local first aiders and external rescue personnel.

The second link, early C.P.R., is a set of actions that the first aider performs in sequence to assess and support airway, breathing and circulation.

The third link, early defibrillation, is the delivery of a shock to the heart to convert the heart’s rhythm from VT to a normal rhythm.

The fourth link, early advanced care, relates to the response of highly trained and equipped pre-hospital EMS personnel (paramedics) who can respond to the patient

and provide for the administration of drugs, advanced airway procedures and other interventions and protocols, prior to the arrival of the casualty at an advanced care facility.

Reprinted with permission from First Aid for Life © Australian Health and Safety PTY LTD 2012. Chain of survival chart reprinted with permission from ZOLL

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