The chain of survival

The chain of survival comprises a series of actions that must be carried out in order and that allow adequate relief to be given to those who have suffered a heart attack or cardiorespiratory arrest. We should all know her.

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The chain of survival is a series of steps that must be carried out when a person suffers a heart attack or respiratory arrest . The objective is to increase the chances that you will not lose your life and decrease the damage or sequelae that may ensue.

Cardiorespiratory arrest outside the hospital is one of the leading causes of death in Europe and worldwide . To face this situation, the American Heart Association (AHA) proposed the survival chain, in 1991. It is intended that all people know it and can apply it if necessary.

When a heart attack or cardiorespiratory arrest occurs, timing is crucial. The faster you act, the greater the victim’s chances of surviving. The chain of survival tells us what are the basic steps to follow to help a person in those cases.

Steps of the survival chain

The central purpose of applying the survival chain is for a person to breathe again or for their heart  to beat again . The steps to follow vary a little, depending on whether it is an adult or a child who has suffered cardiac arrest.

The adult survival chain includes the following links:

  1. Identification and alert:implies recognizing that a person has cardiac arrest . The first thing to do is ask someone to call an ambulance, while the resuscitation maneuvers begin.
  2. Manual cardiopulmonary resuscitation (CPR): Itis performed manually and includes chest compression and mouth-to-mouth breathing. It is a vital action to preserve the life of the affected person.
  3. Electric defibrillation:means using an electric defibrillator  to decrease the arrhythmia. Both this and the previous step seek to restore the normal rhythm of the heartbeat.
  4. Advanced CPR or life support:corresponds to the professional care that the patient receives, once the ambulance arrives.

Myocardial infarctions happen suddenly and can occur on public roads, hence the importance of knowing the chain of survival

Keep reading: Do we know how to recognize the symptoms of a heart attack?

Child survival chain

In the case of children, the chain of survival presents some variations. In these situations it is very important to perform the  manual CPR maneuvers as soon as possible, even as a previous step to ask for help. Time is a more critical factor when children are involved .

In this case, the links are as follows:

  1. Prevention:paying attention to the state of children while they sleep or eat is essential. In general, cardiac arrests in children under 8 years of age are the result of shock or respiratory failure.
  2. Resuscitation:resuscitation maneuvers must be carried out very early. They are essential, especially during the first two minutes.
  3. Call emergency:after two minutes of resuscitation, help is requested.
  4. Treatment:corresponds to effective advanced life support or professional help.
  5. Monitor:includes post-recovery care for cardiac arrest.

Recognition and early CPR

Recognition is essential and constitutes the first link in the chain of survival. The symptoms of cardiac arrest are:

  • Severe chest pain:usually on the left side
  • Excessive cold sweating
  • Vertigo or dizzy
  • Loss of consciousness or fainting

It is important to secure the area, that is, take the person to a place that does not involve any risk. In the meantime, you have to speak loudly to her and try to make her answer, or stammer, to see if she is still conscious. If the helper is alone, he should scream for help from others to call 911.

What follows is to perform resuscitation maneuvers, which basically consist of putting the person on a hard surface and hyperextending his neck. Then check to see if he is breathing and, if so, lay him on his side. If you are not breathing, you should apply cardiac massage and ventilation by mouth-to-mouth breathing .

The survival chain is a key factor in saving lives

Find out more: How to recognize the differences between a heart attack, cardiac arrest and stroke

Early defibrillation and aftercare

While these actions are taking place, those present should be asked to locate a defibrillator. Many public places have them, and it is also common for the police or fire department to carry them. Defibrillation is the most effective measure to get the heart working.

It is simply an electric shock to help the heart work again. If defibrillation is carried out in the three to five minutes after arrest, the chances of survival are increased by 50 to 70%.

What follows is to wait until medical personnel are present and to be responsive to your questions . In the case of children, it is necessary to ensure that they are left in the hands of a responsible adult relative, or an institution that guarantees their care.


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