title text reads chain of survival and a digital drawing of a woman giving a man cpr in a forest woodlands area

The Chain of Survival: Life-Saving Links for First Aid and CPR

Updated 27/08/2024 with new additional information on why the chain matters, its history, if it can be used on infants and children, an faq and some sweet new pics

Did you know that in Australia, only 8% of people who suffer cardiac arrest outside of a hospital survive? It’s a shocking statistic. We need to do better. When someone’s life is on the line, every second counts.

That’s less than one in ten in an emergency. We need to do better

an image of ten unconscious people after a car crash. 9 of them are shaded read to indicate their probable death while one is shaded green to indicate their potential living. a concerned man looks on.

What is the chain of a survival: The Chain of Survival is a set of guiding principles first aiders need to remember when trying to help someone.

There are 4 key steps in the chain, but it’s not so much about steps to take, but more about what you should prioritize and view as important.

If you learn the chain and know what to focus on, not only will it make you a better first aider but can hugely increase a persons chance of survival.

In this blog post, we’ll explore each link in the Chain of Survival and show you how to use them to improve the chances of survival for someone experiencing a medical emergency.

Why the Chain Exists

In the 1960s, doctors such as Dr. James Elam and Dr. Peter Safar noticed that many people were dying from cardiac emergencies because existing treatments weren’t effective enough.

They developed modern CPR, which combined chest compressions with rescue breaths to improve survival rates. Recognizing that CPR alone wasn’t enough, they introduced the “chain of survival,” a comprehensive approach to managing emergencies from start to finish.

By the 1990s, the chain of survival concept was well-established. It includes key steps like quickly identifying a cardiac arrest, starting CPR immediately, using defibrillators, and providing advanced medical care. To ensure these steps were followed, training was expanded to include ordinary people, emphasizing that quick and coordinated action is essential in saving lives during emergencies.

Chain of Survival First Aid Steps

a graphic from the book simply first aid showing the 4 steps of the chain of survival
  1. Early Access: The first step in the Chain of Survival is to recognize an emergency situation and activate the emergency response system by calling 000 (Australia’s emergency number) immediately. Getting help as soon as possible is critical, as it can mean the difference between life and death.
  2. Early CPR: The second step is to begin CPR as soon as possible. CPR (cardiopulmonary resuscitation) involves providing chest compressions and rescue breaths to keep blood and oxygen flowing to the brain and other vital organs. Without CPR, brain damage can occur within minutes of cardiac arrest. By starting CPR early, you can buy time until advanced medical help arrives.
  3. Early Defibrillation: The third step is to use a defibrillator to shock the heart and restore its normal rhythm. Defibrillators are portable devices that can be used to deliver an electrical shock to the heart. They are becoming more common in public places like shopping centers, airports, and sporting venues, and can be used by anyone, even those without medical training.
  4. Early Advanced Care: The final step in the Chain of Survival is to provide advanced care, including medications and advanced airway management, to people who require further treatment in a hospital setting.

Lets dig a little deeper on each point.

Early Access

In many emergency situations, time is of the essence, and every second counts. That’s why it’s essential to call for help as soon as possible by dialing 000 (Australia’s emergency number).

An illustration of a person lying unconscious on the ground. Another person is kneeling beside them, holding a mobile phone to theirear. The background contains a building and some trees.

Seem’s easy right? Not always. Every year, there are stories of people who fail to call for help in an emergency situation. In some cases, people assume that someone else will call for help, while in others, people are simply unsure if the situation warrants an emergency response. However, in emergency situations, it’s always better to be safe than sorry. Remember, if you’re not sure if it’s an emergency, call 000 anyway.

What if you have no signal? If you have no network access 000 will try to find a tower from other networks such as Telstra, Optus Vodafone to put you through. Even if you have no or limited signal, you can often still call for help in an emergency. If not, you’ll need to get to signal, or send someone to do so.

Above all, it’s essential not to have a “she’ll be right attitude” when it comes to emergency situations. Delaying or avoiding calling for help can have severe consequences and can result in unnecessary suffering or loss of life. By calling for help early, you can provide the person in need with the best chance of survival and increase the likelihood of a positive outcome.

Early CPR

The second link in the Chain of Survival is early CPR. We’ve all seen CPR in movies, pushing on the chest and giving breaths helps circulate oxygenated blood to the brain and vital organs to keep them alive so they can be resuscitated.

Why is it a priority to do it as early as possible? Without CPR, the brain can begin to suffer damage within just a few minutes of cardiac arrest. After 10 minutes without oxygen, the chances of survival are extremely low.

a woman kneels next to a man to give cpr ilustration

Effective CPR can double or even triple a person’s chances of survival. There are three key tips for great CPR that anyone can remember: 1) Make sure you push hard enough, 2) Push at the correct rate of 100-120 beats per minute, and 3) Make sure your hands are in the center of the chest

To become a CPR expert, check out our ultimate guide to DRSABCD. This stands for Danger, Response, Airway, Breathing, Compression, and Defibrillation. By following these steps, you can provide effective CPR and help improve the chances of survival for someone experiencing a cardiac arrest.

Remember, in an emergency situation, every second counts. By providing early CPR, you can help to buy time until advanced medical help arrives. Don’t hesitate to act – the life you save could be someone you love.

Early Defibrillation

an illustration of someone holding a portable defibrillator in a case with a yellow lightning bolt

Have you ever seen a defibrillator in a public place like a shopping center or airport? These portable devices can be real lifesavers in emergency situations. The third link in the Chain of Survival is early defibrillation, which involves using a defibrillator to deliver an electrical shock to the heart and restore its normal rhythm.

Using a defibrillator is easier than you might think. Modern defibrillators are designed to be user-friendly, and they will even provide voice prompts to guide you through the process. By using a defibrillator as soon as possible, you can help to increase a person’s chances of survival significantly.

You might be wondering, “Why not just wait for an ambulance to arrive and let them handle the defibrillation?” While it’s true that EMS personnel are trained to provide advanced medical care but time is critical in emergency situations like cardiac arrest. The longer a person goes without treatment, the lower their chances of survival.

One study showed that when a defibrillator shock was applied within 3 minutes more than 70% of cardiac arrest victims survived! A huge improvement from the 8% that currently survive. What ambulance could arrive and deliver a shock within 3 minutes? Obviously, it’s so much better for First Aiders to use a defibrillator if one is available.

Early Advanced Care

an illustration of someone being loaded into an ambulance

The final link in the Chain of Survival is early advanced care, which involves providing further medical treatment to the person who requires it. This could include medications, advanced airway management, or other interventions that require a hospital or ambulance.

While the focus of the Chain of Survival is on cardiac arrest, it’s important to remember that other emergencies may also require early advanced care. For example, in the case of a stroke, it’s important to act fast and get medical help as soon as possible to minimize the damage to the brain. Similarly, if someone has been bitten by a snake or spider, quick medical attention is essential to improve the outcome.

Chain of Survival Questions

Yes, the Chain of Survival principles apply equally to adults, children, and infants. While the steps are the same, techniques for CPR and defibrillation may vary based on age. The main idea is to act quickly and follow the sequence: early access to emergency services, early CPR, early defibrillation if appropriate, and early advanced care.

No, there is no specific acronym for the Chain of Survival. The key principle is to remember that all steps start with “early.” Acting quickly is essential, and each step in the chain should be addressed as soon as possible.

The sequence of the Chain of Survival starts with early access to emergency services, followed by early CPR, early defibrillation, and finally, early advanced care.

These are more guiding principles than specific sequences. If your looking for specific steps for first aid in emergencies, look at the DRSABCD Action Plan.

Many countries have their own chain of survival. For first aiders in Australia, the Chain of Survival includes four key steps: early access to emergency services, early CPR, early defibrillation, and early advanced care.

Chain of Survival Wrap up

The Chain of Survival is a set of guiding principles that can help you to respond effectively to an emergency situation. By following the four links – early access, early CPR, early defibrillation, and early advanced care – you can help to improve the chances of survival for someone experiencing a medical emergency.

Remember that every second counts in an emergency, so don’t hesitate to act. Call for help as soon as possible, start CPR if needed, use a defibrillator if available, and provide advanced care as soon as possible.

By learning about the Chain of Survival you can be better prepared to help save a life.

Take the time to learn CPR, familiarize yourself with the DRSABCD guide, and locate the nearest defibrillator in your community. You never know when you may need to use these life-saving skills!

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