The chain of survival
To survive an out of hospital cardiac arrest needs teamwork at every stage. Good communication to request assistance followed by effective, high quality basic life support at the scene and early use of a defibrillator are equally as important as safe transport to hospital and specialist care. Each step is as important as the others. The essential stages of care are known as the “chain of survival”.
The chain of survival varies according to whether your territory falls under the American Heart Association (AHA) or the European Resuscitation Council (ERC). Therefore, please ensure you take note of the diagram applicable to your territory.
AHA ECC Adult Chain of Survival
The links in the new AHA ECC Adult Chain of Survival are as follows:
- Immediate recognition of cardiac arrest and activation of the emergency response system
- Early CPR with an emphasis on chest compressions
- Rapid defibrillation
- Effective advanced life support
- Integrated post-cardiac arrest care
The American Heart Association chain of survival
Publication Name — Circulation.2025;Volume 152, Number 16_suppl_2
Part 4: Systems of Care: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Reprinted with permission, Circulation.2025;Volume 152, Number 16_suppl_2 ©2025 American Heart Association, Inc.
https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms#adult
ANZCOR Medical Chain of Survival
Early recognition and call for help
- to prevent cardiac arrest
Early CPR
- to buy time
Early defibrillation
- to restart the heart
Post resuscitation care
- to restore quality of life
European Resuscitation Council Chain of Survival
Early recognition and call for help
- to prevent cardiac arrest
Early CPR
- to buy time
Early defibrillation
- to restart the heart
Post resuscitation care
- to restore quality of life
The European Resuscitation Council chain of survival