The chain of survival

To survive an out of hospital cardiac arrest needs teamwork at every stage. Good communication to request assistance followed by effective, high quality basic life support at the scene and early use of a defibrillator are equally as important as safe transport to hospital and specialist care. Each step is as important as the others. The essential stages of care are known as the “chain of survival”.

The chain of survival varies according to whether your territory falls under the American Heart Association (AHA) or the European Resuscitation Council (ERC). Therefore, please ensure you take note of the diagram applicable to your territory.

AHA ECC Adult Chain of Survival

The links in the new AHA ECC Adult Chain of Survival are as follows:

  1. Immediate recognition of cardiac arrest and activation of the emergency response system
  2. Early CPR with an emphasis on chest compressions
  3. Rapid defibrillation
  4. Effective advanced life support
  5. Integrated post-cardiac arrest care

The American Heart Association chain of survival


European Resuscitation Council chain of survival


Early recognition and call for help

- to prevent cardiac arrest

Early CPR

- to buy time

Early defibrillation

- to restart the heart

Post resuscitation care

- to restore quality of life

The European Resuscitation Council chain of survival