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Become a Link in the Chain of Cardiac Survival

If someone you love suddenly went into cardiac arrest and stopped breathing, would you know what to do? Many Americans die each year from sudden cardiac arrest, but with the right tools and citizen training, thousands could survive.

During sudden cardiac arrest, the heart muscle stops pumping and quivers, a condition called ventricular fibrillation. A small percentage of patients who suffer a sudden cardiac arrest outside of the hospital survive.

Lives Saved

While celebrating her 48th birthday, Julie Lycksell suddenly collapsed and stopped breathing. Her friend asked someone to call 911, while her husband and a restaurant patron started cardiopulmonary resuscitation (CPR). Within a minute or two, a policeman trained in using an automated external defibrillator (AED) arrived and administered life-saving pulses of electricity. Unlike most sudden cardiac arrest victims, Lycksell had no history of heart trouble, and doctors could not determine why she developed an abnormal heart rhythm.

"The doctor told me it was just a strange thing that happened to me," Lycksell says. "If the policeman hadn't had a defibrillator, I'd be dead."

Learning the Chain of Survival

Rapid initiation of the American Heart Association's chain of survival may save the lives of people who experience sudden cardiac arrest.

Here's what to do:

  • Recognize that there is an emergency. If the person is unresponsive, emergency care should be started.
  • Call for medical help or have someone else call.
  • If there is an AED available, get it (or have someone else get it) and follow the steps on the machine.
  • Start CPR by giving chest compressions. Push in the chest at least two inches at a fast rate of at least 100 compressions per minute.
  • If you are trained in CPR, after 30 compressions, open the person's airway and give two rescue breaths. Then, continue with the chest compressions. If you feel more comfortable, you can give the compressions without the breaths until the ambulance arrives.
Performing CPR

The American Heart Association, American Red Cross, and other organizations conduct classes to teach citizens how to administer CPR. Researchers have found that young people and adults older than 60 were able to learn the life-saving skill online and then successfully perform CPR on a mannequin.

Defibrillators: The Difference Between Life and Death

Early defibrillation plays a key role in improving the odds someone will survive sudden cardiac arrest without brain damage. The American Heart Association's emergency care guidelines place a stronger emphasis on early defibrillation and improved access to AEDs. Heartsaver AED CPR classes include information about how to use the devices.

Many studies have found that about half of those who suffer sudden cardiac arrest will survive when trained people administer CPR and AED CPR. Overall survival rates are improving as more and more communities increase their access to AEDs.

AEDs are found in airports, shopping malls, casinos, community centers, and sports or medical facilities. AEDs can be somewhat costly and are available over the counter, without prescription. If you purchase an AED, be sure to get proper training on how to safely use it.


American Heart Association

Citizen CPR Foundation, Inc.


The College of Family Physicians of Canada

Public Health Agency of Canada


American Heart Association. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science: Part 1 executive summary. American Heart Association website. Available at: Accessed February 10, 2014.

American Heart Association. Hands only CPR. American Heart Association website. Available at: Accessed February 10, 2014.

Cardiac arrest. American Heart Association website. Available at: Accessed February 10, 2014.

Cardiac arrest/adult CPR. American Red Cross website. Available at: Accessed February 10, 2014.

Chen MA, Eisenberg MS, Meischke H. Impact of in-home defibrillators on postmyocardial infarction patients and their significant others: an interview study. Heart Lung. 2002;31:173-185.

Jorgenson DB, Skarr T, Russell JK, Snyder DE, Uhrbrock K. AED use in businesses, public facilities and homes by minimally trained first responders. Resuscitation. 2003;59:225-233.

Chain of survival. American Heart Association website. Available at: Updated November 20, 2013. Accessed February 10, 2014.

Marenco JP. Automated external defibrillators are cost-effective on large and medium capacity commercial aircraft. Evidence-based Healthcare. 2002;6;58-59.

Murray CL, Steffensen I. Automated external defibrillators for home use. Issues Emerg Health Technol. 2005;1-4.

Page RL, Joglar JA, Kowal RC, et al. Use of automated external defibrillators by a US Airline. N Engl J Med. 2000:343:1210-1216.

Terence D, et al. Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med. 2000; 343:1206-1209.

10/15/2010 DynaMed's Systematic Literature Surveillance Bobrow BJ, Spaite DW, Berg RA, et al. Chest compression-only CPR by lay rescuers and survival from out-of-hospital cardiac arrest. JAMA. 2010;304(13):1447-1454.
SOS-KANTO study group. Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study. Lancet. 2007;369(9565):920-926.

Last reviewed February 2014 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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