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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2000 July-August;66(7-8):503-16


language: English

The chain of survival. A review in year 2000

Gullo A., Sallusti R., Trillò G.

From the Department of Anesthesiology and Intensive Care Trieste University School of Medicine, Trieste, Italy


Worldwide about 1 in 1000 adults every year has a sudden cardiac arrest in out-of-hospital. That means 350.000-400.000 persons in the USA alone, 60.000 persons in Italy. Over 70% of times sudden cardiac arrest occurs at home, the remaining 30% in public settings. The chain of survival concept emphasizes four links associated with survival after sudden cardiac arrest corresponding each with a set of actions that have been done as soon as possible—the early access, the early CPR, the early defibrillation, the early ACLS; in order to develop strenght in each link, separate specialized programs are needed, but all of the links must be well connected. The Utstein Style was developed by a task force who suggested a series of recommendations as a starting point for more effective exchange of information about out-of hospital cardiac arrest. The Utstein Style includes a glossary of terms, a template for reporting data from resuscitation studies on cardiac arrest, definitions for time points and time intervals related to an intervention in a resuscitation attempt, definitions of clinical items and outcomes that should be included in reports, and recommendations for the descriptions for how different EMS systems are organized.

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