The American Heart Association has defined a "Chain of Survival" that is now the worldwide guideline for response to sudden cardiac arrest (SCA). Quick action by the first person on-scene can truly save a life.
The Chain of Survival has four lifesaving links:
- Early Access to Care: Call 9-1-1 or EMS immediately
- Early Cardiopulmonary Resuscitation (CPR): Provide CPR to help maintain blood flow to the brain and body until the next step
- Early Defibrillation: Defibrillation is the only way to restart a heart in sudden cardiac arrest. An electronic device known as a defibrillator is used to deliver a shock. Electricity flows from paddles or adhesive electrodes through the chest.
- Early Advanced Care: After successful defibrillation, an emergency team provides advanced cardiac care on-scene, such as intravenous medications. This care continues during transport to the hospital.
Also important in promoting and extending survival from SCA are two additional links:
- Early screening, to help prevent SCA before it happens (see sections about risk factors for SCA)
- Appropriate follow up, which may include an internal cardioverter defibrillator
It's important that people who experience SCA find out if they are candidates for an implantable cardioverter defibrillator (ICD). This small, "pacemaker-like" device has been available since the early 1990s. About the size of a pager, it is implanted in the upper chest, under the skin.
The device contains a battery and computer circuitry, and is connected to your heart with thin, insulated wires. The ICD senses the heart rhythm, provides a shock if needed, and sometimes paces the heart.
Today more than half a million people are protected by ICD therapy, which has been established by the American Heart Association and the American College of Cardiology as the standard of care for many people at proven risk for SCA. The American Heart Association recommends that before a patient is considered for an ICD, the abnormal rhythm must be life-threatening. Treatable causes of the arrhythmia, such as heart attack, inadequate blood flow to the heart, electrolyte imbalance and drug toxicity, should first be ruled out.
Having an ICD implanted does not require open heart surgery or a lengthy hospital stay. Most ICDs last five to seven years before they need to be replaced.
Both screening and follow-up care are essential to helping extend the Chain of Survival so more lives can be saved.