Emergency medical services and in-hospital resuscitation (also known as code blue or code 99) systems are the most effective means currently known to rescue patients from SCD. Survival from pulseless VT or VF is inversely related to the time interval between its onset and its termination. Each minute that a patient remains in VF, the odds of survival decrease by 7 to 10 percent. Survival is optimal when both CPR and advanced cardiac life support (ACLS), including defibrillation and drug therapy, are provided early.
The American Heart Association has introduced the "chain of survival" concept to represent a sequence of events that ideally should occur to maximize the odds of successful resuscitation from cardiac arrest.8 The links in the chain include early access (recognition of the problem and activation of the EMS system by a bystander), early CPR, early defibrillation for patients who need it, and early advanced cardiac life support.
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