Chain of Survival

The ‘Chain of Survival’, an internationally recognised concept summarises the important components of successful resuscitation.

The first three link in the chain are widely agreed and is well covered in national and international guidelines. The emergency physician is one of the initial points of contact who is responsible for effective resuscitation and visits factors like co-morbidities, arrest events or do not resuscitate orders. This has direct influence on decision like continuation of resuscitation, likelihood of survival with good neurological outcome and lays the platform for the equally vital post-resuscitation care. The final link of post-resuscitation care and its components which offer the best probability of survival are less well defined. This is highly influenced by the hospital to which person is taken, cardiac interventional procedures, the indications and aims of various medical interventions in the intensive care unit, the indications for implantable defibrillators or cardiac resynchronisation devices, and optimal arrangements for cardiac and neurological rehabilitation.