The chances of survival following a cardiac arrest are considerably

improved if there is a rapid, coordinated response to the emergency.

The HSE supports the American Heart Association’s ‘Chain of Survival’

concept which is a process of four steps to be enacted to ensure an

effective response to an acute Cardiac Emergency.


1.    Early access to Emergency Medical Services (EMS)

This involves recognising that a person is in cardiac arrest and

calling for help by phoning 112 (the single European emergency

call number) or 999. There is considerable lack of awareness

in the community as to the appropriate action to be taken in

the event of a collapse. It is advisable to always contact the National

Ambulance Service first before moving on to the next step so that

professional help can be dispatched immediately. In addition,

once connected to the emergency service, immediate assistance

can be given by way of telephone advice to support you.


2.    Early Cardiopulmonary Resuscitation (CPR)

This is a manual technique for attempting to revive collapsed

individuals using rescue breathing and chest compressions.

When someone has a Cardiac Arrest this procedure is undertaken

in order to keep the person’s brain, heart and other vital organs

supplied with blood and oxygen until medical help arrives. In

order to be effective, training in the use of CPR is essential.

From the moment of collapse to defibrillation the chance of

survival decreases by 7 to10% per minute when CPR is not being


3.    Early Defibrillation

Defibrillation is the delivery of an electric shock to a person’s

chest to help restore the normal function of the heart. In order

to be effective and safe, training in the use of a defibrillator is


4.    Early Advanced Cardiac Life Support (ACLS)

Advanced medical care is usually given in a hospital setting,

however ACLS can also be delivered in a pre-hospital or

community setting by trained personnel.  In the out of hospital

setting in Ireland, this is most commonly delivered by General

Practitioners, but increasingly by Advanced Paramedics.

The Chain is only as strong as its weakest link and if any of the links

are missing when someone suffers a sudden cardiac arrest, the chance

of survival is limited.