The American Heart Association's basic life support guidelines are detailed by the chain of survival. The chain of survival is a protocol that helps first responders, emergency medical providers and certified civilian responders provide essential care to a victim of choking or cardiac or respiratory arrest. The goal of the chain of survival is to increase the victim's chance for recovery through early action.
Early Access
The chain of survival as outlined for adults is first, early access, followed by early CPR, early defibrillation and early advanced care. To accomplish early access means first ensuring that the scene of the incident is safe. Then it is necessary to assess the victim's consciousness by asking "Are you okay?" Next, activate EMS by calling 9-1-1, or other local emergency number, and obtain an automatic electronic defibrillator, or AED, if available.
The 9-1-1 dispatcher will want to keep the caller on the phone to obtain continuous information about the scene and victim. Be sure to tell the dispatcher if you are alone or need to leave the phone to get an AED. Do not hang up. Many 9-1-1 systems are enhanced with capabilities such as caller ID and can locate the address of the incident for responding EMS personnel.
Three cycles of CPR should be done before if the rescuer is alone. If other people are available, the rescuer should designate a specific individual to make the emergency call and another to retrieve the AED.
Early CPR
If the victim is non-responsive, start cardiopulmonary resuscitation, or CPR. First, assess the patient's breathing and pulse. The victim's airway should be opened using a head tilt and chin lift only if no neck or spine injury is suspected. If it is possible that spinal injury has occurred, the airway can be opened using the jaw thrust technique. Next, visually check for foreign objects that may be obstructing the airway. Remove any objects with a . Do not do a blind finger sweep. Begin chest compressions and rescue breathing. Complete five cycles of CPR before continuing on to the next step: early defibrillation.
Early Defibrillation
Electrical signals become disorganized when the heart is in . The impulses cannot effectively contract the heart muscle to pump blood into circulation. This is called ventricular fibrillation. The AED sends a countershock through the heart muscle to defibrillate or reorganize the cardiac current. AEDs come with easy-to-understand directions; many have digitalized voice instructions. This helps them to be used efficiently by lay rescuers. Most public buildings and transportation centers are equipped with AEDs.
Early Advanced Care
When EMS personnel arrive at the scene, they will stabilize and then transport the patient to the hospital. Activating EMS early in the chain of survival helps ensure early access to advanced care. Advanced care can be started in the pre-hospital setting by certified paramedics. Paramedics are trained in advanced life support techniques. Advanced care will also be provided by nurses and physicians in the hospital where they have access to more diagnostic and life-preserving machines.
Considerations
There is a different chain of survival for infants and children. It is begins with the prevention of cardiac arrest followed by the four links outlined above. Prevention is especially important in this chain of survival because accidents are the number one killer of young children.
Childproofing homes and areas where children play is one important way to prevent injury. For example, ensure that unused electrical sockets are covered. Lock up cupboards containing harmful chemicals. Keep stairs and doorways secure with childproof gates. Lock doors or use childproof door handle covers to keep children from wandering outside without supervision.
History
The AHA was formed in 1924 in response to poor awareness of heart disease. The first CPR protocols were developed by the AHA in 1966. They have been updated continuously every six years. The mission of the AHA is to reduce the impact of cardiovascular diseases and stroke.
Tags: chain survival, calling 9-1-1, cardiac arrest, early access, finger sweep