The chain of survival: Not all links are equal

  • Charles D. Deakin
    Corresponding author at: South Central Ambulance Service, Southern House, Otterbourne, SO21 2RU, U.K.
    South Central Ambulance Service, Otterbourne, SO21 2RU, UK

    NIHR Respiratory BRU, University Hospital Southampton, Southampton, SO16 6YD, UK
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      The chain of survival aims to demonstrate the interrelationship between key stages of resuscitation and emphasises the need for all links to be effective in order to optimise the chances of survival. The contribution of each of the four links diminishes rapidly as patients succumb at each stage and the actual attrition rate results in rapidly decreasing numbers of patients progressing along the chain.
      This revised representation adjusts the area of each link in order to graphically represent the flow of patients through the chain. Greatest benefit in improving outcome will be achieved by focussing on improving care at links in the chain where there is the greatest number of patients.


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