Out-of-hospital Chain of Survival

The term Chain of Survival provides a useful metaphor for the elements of the ECC systems concept.

Chain of Survival

The 5 links in the adult out-of-hospital Chain of Survival are:

  • Recognition of cardiac arrest and activation of the emergency response system
  • Early cardiopulmonary resuscitation (CPR) with an emphasis on chest compressions
  • Rapid defibrillation
  • Basic and advanced emergency medical services
  • Advanced life support and post-cardiac arrest care

A strong Chain of Survival can improve chances of survival and recovery for victims of cardiac arrest.

Find a Training Center

Locate an AHA Training Center where you can complete a classroom course in the lifesaving skills of CPR and first aid with an AHA Instructor.


Basic Life Support (BLS)

Basic life support skills including CPR, AED use, and ventilations. Available in two tracks: pre-hospital and in-facility. Results in an AHA BLS Healthcare Provider course completion card.