Chain of survival - wikipedia Chain of survival The chain of survival refers to a series of actions that, properly executed, reduce the mortality associated with cardiac arrest. Like any chain, the chain of survival is only as strong as its weakest link. The four interdependent links in the chain of survival are early access, early CPR, early defibrillation, and early advanced cardiac life support Contents 1 Background 2 Early access 3 Early CPR 4 Early defibrillation 5 Early advanced care 6 See also 7 References 8 External links Background The `` chain of survival '' metaphor was first published in the March 1981 newsletter of CPR for Citizens in Orlando, Florida. It was further developed by Mary M. Newman of the Sudden Cardiac Arrest Foundation, and used as a slogan for the 1988 Conference on Citizen CPR, and described in an article she wrote for the Journal of Emergency Medical Services in 1989, and in an editorial she wrote for the first issue of Currents in Emergency Cardiac Care in 1990. The American Heart Association adopted the concept and elaborated on it in its 1992 guidelines for cardiopulmonary resuscitation and emergency cardiac care, The International Liaison Committee on Resuscitation ( ILCOR ) echoed the concept in 1997. Early access Ideally, someone must recognize an impending cardiac arrest or otherwise witness the cardiac arrest and activate the EMS system as early as possible with an immediate call to the emergency services. Unfortunately, many persons experiencing symptoms ( for example, angina ) that may lead to a cardiac arrest ignore these warning symptoms or, recognizing these warning symptoms correctly, fail to activate the EMS system, preferring to contact relatives instead ( the elderly often contact their adult offspring rather than contact emergency services ). Early CPR To be most effective, bystanders should provide CPR immediately after a patient collapses. Properly performed CPR can keep the heart in a shockable ventricular fibrillation for 10 -- 12 minutes longer. Early defibrillation Most adults who can be saved from cardiac arrest are in ventricular fibrillation or pulseless ventricular tachycardia. Early defibrillation is the link in the chain most likely to improve survival. Public access defibillation may be the key to improving survival rates in out - of - hospital cardiac arrest, but is of the greatest value when the other links in the chain do not fail. Early advanced Care Early advanced cardiac life support by paramedics is another critical link in the chain of survival. In communities with survival rates > 20 %, a minimum of two of the rescuers are trained to the advanced level. In some countries, EMS delivery may be performed by ambulance officers, paramedics, nurses, or doctors. See also Cardiac arrest Cardiac Arrest Registry to Enhance Survival Cardiopulmonary resuscitation Defibrillation References ^ Jump up to : `` Part 12 : From Science to Survival - Strengthening the Chain of Survival in Every Community, '' Circulation 2000 ; 102 : I - 358 ^ Jump up to : Bossaert LL ( 1997 ). `` Fibrillation and defibrillation of the heart ''. British Journal of Anaesthesia. 79 ( 2 ) : 203 -- 13. doi : 10.1093 / bja / 79.2. 203. PMID 9349131. Jump up ^ Newman M ( 1989 ). `` The chain of survival concept takes hold ''. JEMS. 14 : 11 -- 13. Jump up ^ Newman MM ( 1990 ). `` The Chain of Survival : Converting a Nation ''. Currents in Emergency Cardiac Care. 1 ( 1 ) : 3. Jump up ^ Cummins RO, Ornato JP, Thies WH, Pepe PE ( 1991 ). `` Improving survival from sudden cardiac arrest : the `` chain of survival '' concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association ``. Circulation. 83 ( 5 ) : 1832 -- 47. doi : 10.1161 / 01. cir. 83.5. 1832. PMID 2022039. Jump up ^ `` Guidelines for cardiopulmonary resuscitation and emergency cardiac care. Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Part I. Introduction ''. JAMA. 268 ( 16 ) : 2171 -- 83. 1992. doi : 10.1001 / jama. 268.16. 2171. PMID 1404767. Jump up ^ `` Strengthening Each Link in the Chain of Survival, '' American Heart Association, Accessed July 10, 2007. Jump up ^ Eisenberg MS, Bergner L, Hallstrom A ( 1979 ). `` Cardiac resuscitation in the community. Importance of rapid provision and implications for program planning ''. JAMA. 241 ( 18 ) : 1905 -- 7. doi : 10.1001 / jama. 241.18. 1905. PMID 430772. Jump up ^ `` Early Defibrillation, '' Circulation 1997 ; 95 : 2183 - 2184. External links `` The Links in the Chain of Survival, '' American Heart Association `` Chain of Survival : Converting a Nation, '' Citizen CPR Foundation ( 1 ) Retrieved from `` https://en.wikipedia.org/w/index.php?title=Chain_of_survival&oldid=861734587 '' Categories : Cardiology Medical terminology Public health education Hidden categories : All articles with dead external links Articles with dead external links from November 2016 Articles with permanently dead external links Talk Contents About Wikipedia Čeština Deutsch Italiano 日本 語 Polski Português Українська Edit links This page was last edited on 29 September 2018, at 16 : 47 ( UTC ). About Wikipedia

Question: the correct order of the emergency chain of survival is
Answer: early access