The chain of survival consists of four actions that, carried out consecutively and in a short period of time, have proven to be the most efficient when treating patients in cardiorespiratory arrest (CRP).
The chain of survival or chain of life is a phrase to describe a series of actions that in the face of a cardiorespiratory arrest make it possible for the victim to survive. Each link in the chain of survival represents a critical intervention.
The chain will be as strong as its weakest link, the chain will be as strong as the efficiency in all its links without leaving the importance of precocity in all of them; Efficacy and timing are paramount, as the chances of survival are diminished and the neurological integrity of the patient may be impaired.
People without first aid knowledge intervene as factors in the chain of survival, hence the importance of preparing the population in CPR training or cardiopulmonary resuscitation.
Medical healthcare in hospitals and healthcare centers is fast and efficient, however, the arrival time of ambulances is often excessive due to the distances and routes. In those critical initial moments, knowing the chain of survival and putting it into practice exponentially increases the survival of the victim, providing care coverage without gaps.
Links in the chain of survival in adults
- Early access to Emergency Systems.
- Initiation of cardiopulmonary resuscitation maneuvers or establishment of life support.
- Early defibrillation.
- Establishment of Advanced Life Support, continuity of care.
Early access to Emergency Systems
Early access is the first link, it is the link that sets the entire chain of survival into operation, and is usually carried out by non-health personnel.
Early access consists of 2 phases:
- Recognition of early warning signs such as a heart attack, cardiorespiratory arrest, stroke, drowning, etc.
- Activation of the Emergency Medical System by calling 112.
Recognize the symptoms that can be premonitory of life risk such as the sudden appearance of pain in the chest, episode of loss of consciousness, sweating, intense fatigue, etc.
The role of the first respondent is essential and on certain occasions it is vital, having to start Basic Life Support, recognize and assess their breathing.
The call to 112 for medical emergencies goes through a series of response phases integrated into the management computer platform; the emergency and emergency coordinating center follows a protocol of necessary and essential questions.
Cardiopulmonary resuscitation maneuvers or establishment of basic life support
The second link is Establish early basic life support as soon as possible, the rapid onset of these resuscitation maneuvers positively influences the early recovery of spontaneous pulse and the absence of neurological sequelae. Be very aware of correctly securing the scene, making the place safe for the rescuer and the patient.
Basic CPR replaces vital functions that have ceased, the body's cells stop receiving oxygen, and all vital organs are highly sensitive to this deficit. Survival rates increase when resuscitation is initiated by bystanders before the arrival of emergency medical services.
The dissemination of theoretical and practical knowledge in life support and resuscitation maneuvers are essential for the proper development of this second link.
If basic CPR maneuvers are not applied in the first 5 minutes after suffering a cardiorespiratory arrest, the chances of survival are very low.
Early defibrillation is access to semi-automatic external defibrillators by citizens or non-healthcare personnel, for it the population should be trained in the use of the defibrillator. These portable defibrillation kits have made it easy to learn and use.
Early defibrillation is capable of reversing a cardiorespiratory arrest by up to 90% if it is performed in the first minute, decreasing by 10% for each minute of delay in its application.
Establishment of advanced life support
This link indicates the need to complete the stabilization of vital functions and action on the triggering cause. Admission to the ICU must be done directly, so coordination between out-of-hospital and hospital emergency services is essential.