The phrase Cardiac Chain of Survival is an acronym that the American Heart Association uses to describe the events that need to occur in order to increase the chances of one's survival from cardiac arrest.

In this lesson, we will be covering the Cardiac Chain of Survival for out-of-hospital care as well as in-hospital care. What follows after this important information is a warning of what you might expect to feel if you're ever put into a rescue situation.

The idea behind the Cardiac Chain of Survival is that every step in the chain is as critical as a link is in a chain. Perhaps you've heard that a chain is only as good as its weakest link. The same can be said for the Cardiac Chain of Survival. However, in this case, a weak link also includes any delays in moving from one link to another; delays make cardiac arrest rescue attempts more ineffective.

Pro Tip: It's important to remember that maximizing one's chance of survival and recovery from sudden cardiac arrest is dependent on a strong Cardiac Chain of Survival.

Out-of-Hospital Cardiac Arrest (OHCA) Chain of Survival

The out-of-hospital Cardiac Chain of Survival includes the following links:

  1. The activation of emergency response - the recognition of cardiac arrest and the activation of the emergency response system.
  2. High-quality CPR - early CPR with an emphasis on high-quality chest compressions.
  3. Defibrillation.
  4. Advanced Resuscitation - advanced resuscitation by emergency medical services (EMS) personnel and other healthcare providers.
  5. Post cardiac arrest care.
  6. Recovery - recovery includes additional treatment, observation, rehabilitation, and psychological support.

In-Hospital Cardiac Arrest (IHCA) Chain of Survival

For the in-hospital Cardiac Chain of Survival, there is a slight variation. The in-hospital chain includes the following links:

  1. Early recognition and prevention - early recognition and prevention of sudden cardiac arrest.
  2. The activation of the emergency response system.
  3. High-quality CPR - early CPR with an emphasis on high-quality chest compression.
  4. Defibrillation.
  5. Post cardiac arrest care and recovery.

The Cardiac Chain of Survival is a helpful tool to help you remember and organize the steps of cardiac care both in-hospital and out. However, it is even more important to focus on eliminating any fears you might have that could cause indecision and delays in executing these steps quickly and correctly.

Warning: The biggest hurdle may likely be overcoming the fear that prevents people from getting involved in the first place. Knowing that you might expect this fear to arise should also help you prepare for it. And in the next lesson, you'll discover why you really have nothing to lose in trying, and neither does the victim.

Even after decades of CPR training being readily available to everyone, the biggest problem we find isn't that people are doing CPR incorrectly. It's that people just aren't doing CPR enough. They let the fear creep in and prevent them from possibly saving a life.

Almost all of the reasons people fail to rescue can be categorized into The 5 Fears of CPR Rescue.

If you haven't already, please watch our video on The 5 Fears of CPR Rescue and learn how you can remove the fears of getting involved in rescuing someone in cardiac arrest and providing care that just might give that person their best and only chance of survival.

Related Q&A

What are the cardiac chain of survival steps?

The steps for out-of-hospital cardiac arrest are:

  1. Activate EMS
  2. High-quality CPR
  3. Defibrillation
  4. Advanced resuscitation
  5. Post cardiac arrest care
  6. Recovery