Dr Richard Cummins from Seattle, USA discovered that if a series of events took place in a set sequence, a heart attack victim has a greater chance of survival. These events are known as "the chain of survival".

 

• Early access. The sooner 999 (or 112) is dialled*, the sooner treatment can commence. Whilst CPR is important, early treatment with a defibrillator and Advanced life support are crucial in survival and therefore the sooner 999 is dialled, the better
• Early CPR. CPR (Cardiopulmonary Resuscitation) attempts to keep the casualty oxygenated until more advanced treatment is available. Breathing for the casualty provides Oxygen into the lungs (and thence into the bloodstream). Chest compressions then circulate the oxygen-enriched blood around the body to where it is required. CPR on its own will not restart a heart. However, it will buy some time until a defibrillator arrives.
• Early Defibrillation. When a heart initially stops following a heart attack, it actually enters an uncontrolled state where electrical activity is buzzing around randomly rather that the ordered activity found in normal operation. A defibrillator applies an electrical shock to the heart which momentarily stops it. The heart has an inbuilt pacemaker and following the shock, it will attempt to re-establish control of the heart and start beating regularly.
• Early ALS (Advanced Life Support). Treatment with drugs such as Adrenaline and with fluids in the case of severe blood loss will all assist in treatment. The sooner these are applied, the better the chance of survival.

A casualty that has this chain of events occurring soon after a heart attack will have the greatest chance of survival. If any links in the chain are missing, the chances of survival will be decreased.

If you would like to know more about learning CPR, then the British Heart Foundation promotes an initiative called Heartstart UK which provides people with the opportunity to learn the vital skills of Emergency Life Support. Click here to go to its website for further information.

* In Europe, 112 is the established emergency dialling code. In Great Britain, 999 has been the number of choice. 112 also works in Great Britain, but 999 will not work in Europe.