The term Chain of Survival provides a useful metaphor for the elements of the ECC systems concept. The 6 links in the adult out-of-hospital Chain of Survival are: Recognition of cardiac arrest and activation of the emergency response system; Early cardiopulmonary resuscitation (CPR) with an emphasis on chest compressions; Rapid defibrillation

Explore the AHA’s CPR and ECC algorithms for adult, pediatric, and neonatal resuscitation. Learn the latest evidence-based recommendations.

The term Chain of Survival provides a useful metaphor for the elements of the ECC systems concept. The 6 links in the adult out-of-hospital Chain of Survival are: Recognition of cardiac arrest and activation of the emergency response system (calling 9-1-1 in the US)

After cardiac arrest is recognized, the Chain of Survival continues with activation of the emergency response system and initiation of CPR. The prompt initiation of CPR is perhaps the most important intervention to improve survival and neurological outcomes.

Chains of Survival (Figure 3). • The universal Adult Cardiac Arrest Algorithm was modified to emphasize the role of early epinephrine administration for patients with nonshockable rhythms (Figure 4). • Two new Opioid-Associated Emergency Algorithms have been added for lay rescuers and trained rescuers (Figures 5 and 6).

Previous systems of care guidelines have identified a Chain of Survival, beginning with prevention and early identification of cardiac arrest and proceeding through resuscitation to post–cardiac arrest care.

CPR, especially if administered immediately after cardiac arrest, can double or triple a person’s chance of survival. According to 2021 US data for adult OHCA only, survival to hospital discharge was 9.1% for all EMS-treated non-traumatic OHCA cardiac arrests.

Given the public health implications of OHCA, resuscitation in the COVID-19 era must strive to correctly balance the best practices achieved by the links in the chain of survival with the added risks of COVID-19.

The American Heart Association Chain of Survival A strong Chain of Survival can improve chances of survival and recovery for victims of cardiac arrest, stroke and other emergencies. The five links in the American Heart Association adult Chain of Survival are • Recognition and activation of the emergency response system • Immediate high ...

Chain of Survival: A new link—recovery— has been added. Full recovery can take a year or more. Because recovery continues long beyond initial hospitalization, provide assessment and support for physical, cognitive, and psychosocial needs. Infographic by Samuel Wilson, MD candidate. Template designed by Sparsh Shah, MD.