1st Link: Recognizing Arrest and Getting Help: Magnifying Glass Icon

As soon as cardiac arrest is evident, responders call for help. The steps include:

• The responder must recognize collapse. 
• In IHCA, families can be trained to recognize signs of cardiovascular distress before a cardiac arrest occurs.
• Rapid response team members arrive and begin administering care.

The key to this is the prevention of cardiac arrest through early recognition of the event and early onset of CPR. This can be accomplished by a readily available CPR-trained individual.

2nd Link: Activating Resuscitation Team: Phone Icon

Patients in cardiac arrest do best when they receive immediate CPR and defibrillation within 5 minutes of arrest. The code or rapid response team responds and recognizes potential cardiac arrest, initiating the appropriate response (BLS or ACLS).

3rd Link: High-quality CPR: Hands Icon

High-quality CPR with excellent chest compressions is the key to saving lives. CPR is based on cycles of 30 excellent chest compression and two breaths with a basic airway, followed by continuous compressions and a breath every 6 seconds with an advanced airway. Limiting unnecessary interruptions in compressions and ensuring that pauses are limited to 10 seconds or less is a key component to providing high-quality CPR. This intervention can be provided by anyone who recognizes the cardiac arrest.

4th Link: Defibrillation: Heart Icon

Early defibrillation is key for patients who have a shockable rhythm: ventricular fibrillation or pulseless ventricular tachycardia. The goal is to provide defibrillation within 3 to 5 minutes of arrest, as this improves survival rates. For every minute that passes without defibrillation, the survival rate decreases by up to 10%.³ This intervention is typically provided by the in-hospital code team.

5th Link: Post-Arrest Treatment: Bed Icon

Following the acute management of cardiac arrest, integrating multiple areas of care such as cardiovascular, metabolic, and neurologic care is instrumental in increasing the survival rate following ROSC.

The primary goals of post-arrest treatment are to:

1. Maintain cardiovascular perfusion.
2. Transport the cardiac arrest patient safely to the intensive care unit.
3. Identify and manage the cause of cardiac arrest while preventing recurrence.

The secondary goals of post-arrest treatment are to: 

1. Maintain a body temperature that optimizes neurologic function and survival.
2. Manage treatment of acute coronary syndrome.
3. Manage mechanical ventilation and reduce organ injury.
4. Maintain organ function and take steps to decrease organ injury.
5. Determine the patient’s recovery prognosis.
6. Transition to the appropriate rehabilitation service.

6th Link: Recovery

The final link includes rehabilitation assessment and treatment before hospital discharge. This recovery link involves doing a need assessment and providing rehabilitation services for both the patient and their family. 

These efforts involve assessment of:

• Cardiopulmonary status
• Neurologic status
• Return to work
• Post-traumatic stress
• Fatigue