What is the Chain of Survival

Written by | 02 Nov 2016

If the words Sudden Cardiac Arrest (SCA) stir up fear in you then you’re not alone. When the heart stops beating unexpectedly with no prior warnings like chest pain or shortness of breath, Sudden Cardiac Arrest can be fatal extremely quickly.

The facts back up this fear – 95% of victims of SCA die before reaching hospital. Did you know this number can be reduced dramatically, to the point where the survival rate can be as high as 75%? With 30,000 people in Australia suffering a SCA each year, that is a lot of deaths that are largely preventable if bystanders know what to do. If it was your loved one, you would want to know that those around them did everything possible to help.

This is where the Chain of Survival comes in. It is a series of actions that can be taken to reduce these many thousands of deaths. The steps in each section of the chain of survival are closely linked to the next.

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Early Access

Recognising that a cardiac arrest is happening is the first step – some people don’t realise the seriousness of the situation until it is too late. A First Aid course can help you learn how to identify this in a casualty by thoroughly checking breathing and consciousness. Once it has been established the casualty is unconscious and not breathing, an ambulance must be called immediately to ensure defibrillation and life support arrives as soon as possible. Unfortunately in the panic of an emergency, some will debate the need for an ambulance and call friends or family instead. In a cardiac arrest, those wasted minutes could be the difference between life and death. Being a little embarrassed by a false alarm is a lot better than being devastated by the loss of a loved one.

Early CPR

If CPR starts within 4 minutes of the heart stopping, oxygenation of vital organs like the brain can be maintained. This is a practical way bystanders can help keep someone alive until better tools arrive. With a ratio of 30 chest compressions to 2 breaths, CPR helps to move blood and oxygen around the body until an automated external defibrillator (AED) arrives or help comes. And you don’t necessarily have to perform breaths to keep the casualty alive.

Early Defibrillation

If CPR is given within 4 minutes and Defibrillation within 8-12 minutes, there is a significantly improved survival rate. Each minute without Defibrillation reduces the chances of survival by 9%. A defibrillator will shock the heart back into action and the best thing is, anyone can use them as they provide audio instructions on the steps to follow. This is why getting more Defibrillators in public places like workplaces, sporting clubs and entertainment precincts is critical if we are to improve survival rates from SCA. There are some public defib programs and initiatives in progress that St John is involved in to help progress this further.

 

Early Advanced Life Support

Medical treatment such as giving medication and stabilising the airway will increase the chance of survival even further. The casualty will need a visit to a hospital for appropriate care and monitoring to ensure their long term health and wellbeing.

There is no doubt that a 95% fatality rate for sudden cardiac arrest is unacceptable. Particularly when there is action we can all take as individuals to help improve survival. Awareness of the steps in the Chain Of Survival, improved knowledge and real life practice of techniques like CPR and defibrillation will assist dramatically. Unfortunately, in reality too many people would be helpless in an emergency situation – frozen by their lack of knowledge and fear. A world where everyone knows what to do during a sudden cardiac arrest would mean more of our loved ones would come home each night, and that is a goal worth pursuing.