Why is the Chain of Survival So Important?


Understanding the 5 Links in the Chain of Survival Can Improve Outcomes for SCA Survivors

The Chain of Survival is a metaphorical depiction of a series of critical actions that rescuers (bystanders or paramedics) need to take to improve the likelihood of survival following a cardiac arrest. Why is it so important? Put simply, knowing and understanding the five key “links” in the chain can vastly reduce mortality rates.


A majority of SCA survivors receive immediate help from bystanders. In fact, the time between the onset of arrest symptoms and care determines the likelihood of survival. Whether you’re a trained medical professional or a layperson, understanding the Chain of Survival can make all the difference.


Need more compelling evidence? The Sudden Cardiac Arrest Foundation reports that “If treatment is not provided within 10 minutes, the survival rate is close to zero. Because minutes count, the public plays a crucial role in saving lives threatened by SCA.”

According to the American Heart Association (AHA), the 5 links in the adult out-of-hospital Chain of Survival are:

  • Recognition of cardiac arrest and activation of the emergency response system

  • Early cardiopulmonary resuscitation (CPR) with an emphasis on chest compressions

  • Rapid defibrillation

  • Basic and advanced emergency medical services

  • Advanced life support and post-cardiac arrest care


Early Recognition and Call for Emergency Assistance

The first link, early recognition of cardiac arrest and the prompt activation of the emergency response protocol, is absolutely essential. When an out-of-hospital cardiac emergency occurs, dial 911 immediately. If the incident should occur on a job site or in a professional setting, the internal alert system should also be triggered, which will improve the odds obtaining of skilled, on-site assistance and equipment as soon as possible.


If someone reports experiencing pain or discomfort in the chest, jaw, neck or back, lightheadedness, nausea, vomiting, shortness of breath, or discomfort in the arm or shoulder, call 911. If an individual is unresponsive and is not breathing, call 911.


If possible, send someone to retrieve the nearest automated external defibrillator (AED).

What’s the Difference Between a Heart Attack and Sudden Cardiac Arrest? Well, in short, a heart attack is caused by a blockage in a vein or artery and SCA is caused by an electrical malfunction in the heart. Cardiac arrest may be caused by a heart attack, SCA, drowning, electrocution, or an obstructed airway. To make matters even more confusing, symptoms of a heart attack may vary and can be different for men than for women.


Don’t hesitate to call 911! It’s always better to be safe than sorry.