What is the Chain of Survival?


When someone suffers a sudden cardiac arrest (SCA) outside of hospital, there’s a chain of events which can increase their chance of survival. This is known as the Chain of Survival Concept. A term first coined by the American Heart Association in 1991, their paper ‘Improving Survival from Sudden Cardiac Arrest: The Chain of Survival Concept’ highlights that all communities should recognise and adopt the principle of early CPR and defibrillation.

So, what is the Chain of Survival? Made up of four links, the first three links in the chain can be performed by members of the public who are practised in basic lifesaving skills. The final link should be carried out by paramedics. If all are carried out in quick succession, you can increase a person’s likelihood of survival from a sudden cardiac arrest.

1. Early access and recognition

The first link in the chain is early access and recognition. This refers to an individual being able to recognise the signs of a sudden cardiac arrest and get help. There are often no symptoms before a cardiac arrest happens, however if someone is in sudden cardiac arrest they:

  • Won’t be responsive
  • Won’t be breathing or breathing normally

If you come across someone who you think is in sudden cardiac arrest, immediately call 999 and start CPR.

2. Early CPR

The second link in the Chain of Survival is early CPR. This involves performing chest compressions in order to keep a person’s heart going until a defibrillator arrives. If you’d like to give lifesaving training to your colleagues and employees, there are many organisations that offer CPR training courses for members of the public, including the British Heart Foundation and St. John’s Ambulance Service. You can also organise courses for your workplace or school.

Want to improve your lifesaving skills? Read our blog on how to perform CPR.

3. Early defibrillation

The third link is early defibrillation. Having an AED on hand in a sudden cardiac arrest emergency can be the difference between life and death. A defibrillator is used to shock the heart to return it to its normal rhythm. For every minute that passes without defibrillation, the individual’s chance of survival decreases by 10%.1

Installing a defibrillator in your workplace or community space is the best way to ensure you have a defibrillator nearby. At Cardiac Science, our AED products are suitable for a range of working environments and are always ready to be used. If you’d like to find out more about getting a defibrillator for your community, get in touch with us today.

What is a defibrillator?

4. Early advanced care

The fourth link in the chain is early advanced care. This relates to having a speedy response from paramedics who can perform more advanced lifesaving procedures. Advanced life support should arrive within eight minutes for the best chance of survival.

Ensuring your home, workplace or community space is fully equipped to deal with a sudden cardiac arrest emergency is the best way to improve an individual’s likelihood of recovery. If you’d like to discuss our defibrillator products in more detail, contact us today.

Find out how a timely installation of a defibrillator in Ruislip saved the life of Kevin Twomey.

Learn more about sudden cardiac arrest and defibrillators in our Education hub

1 BHF Cardiovascular Disease Statistics – UK Factsheet