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.