LIFE SAVING SKILLS IN THE BASIC LIFE SUPPORT

A: CHAIN OF SURVIVAL
The chain of survival refers to a series of actions that, when properly executed, reduce the mortality
associated with sudden cardiac arrest in children and adult.

The "chain of survival" metaphor was developed by Mary M. Newman in 1987. It was used as a slogan for the 1988
Conference on Citizen CPR, described in an article she wrote for the Journal of Emergency Medical Services in 1989, and
promoted in an editorial she wrote for the first issue of Currents in Emergency Cardiac Care in 1990. The American Heart
Association later adopted the concept and elaborated on it in its 1992 guidelines for cardiopulmonary resuscitation and
emergency cardiac care. The International Liaison Committee on Resuscitation (ILCOR) echoed the concept in 1997.

A.1: Pediatric Chain of Survival – illustrates the sequence of critical interventions to prevent death in children. Whether
citizens, caregivers, or healthcare providers, all rescuers share the common purpose of reducing death in children caused
by illness or injury. So the Pediatric Chain of Survival is a reminder that reducing injury and death in children is a shared
responsibility. Saving a child’s life involves a combination of efforts by the community at large, caregivers and healthcare
professionals.

LINKS IN THE PEDIATRIC CHAIN OF SURVIVAL

▣ THE FIRST LINK: Prevention of arrest or injury

◼ Prevention of conditions leading to cardiac arrest refers to preventing diseases or events that may lead to
cardiac arrest or respiratory arrest. In children, the leading cause of death is injury, and vehicular accidents
are the most common causes of fatal childhood injuries and child passengers’ safety seats can reduce the
risk of death.
▣ THE SECOND LINK: Early and effective bystander CPR
◼ It is the most effective when started immediately after the victims collapse. The probability of survival
approximately doubles when it is initiated before the arrival of EMS. It is associated with successful return of
spontaneous circulation and neurologically intact survival in children.
▣ THE THIRD LINK: Rapid access to EMS system
◼ It is the cornerstone therapy for patients who have just suddenly collapsed probably due to ventricular
fibrillation and pulse-less ventricular tachycardia.
▣ THE FOURTH LINK: Early and effective life support
◼ Initial steps in stabilization provide warmth by placing baby under a radiant heat source, position head in a
“sniffing” position to open the airway, clear airway with bulb syringe or suction catheter, dry baby and
stimulate breathing.
▣ THE FIFTH LINK: Integrated post- cardiac arrest care
◼ Post cardiac arrest care after return of spontaneous circulation (ROSC) can improve the likelihood of patient
survival with good quality of life.