<P> The chain of survival refers to a series of actions that, properly executed, reduce the mortality associated with cardiac arrest . Like any chain, the chain of survival is only as strong as its weakest link . The four interdependent links in the chain of survival are early access, early CPR, early defibrillation, and early advanced cardiac life support </P> <P> The "chain of survival" metaphor was first published in the March 1981 newsletter of CPR for Citizens in Orlando, Florida . It was further developed by Mary M. Newman of the Sudden Cardiac Arrest Foundation, and used as a slogan for the 1988 Conference on Citizen CPR, and described in an article she wrote for the Journal of Emergency Medical Services in 1989, and in an editorial she wrote for the first issue of Currents in Emergency Cardiac Care in 1990 . The American Heart Association adopted the concept and elaborated on it in its 1992 guidelines for cardiopulmonary resuscitation and emergency cardiac care, The International Liaison Committee on Resuscitation (ILCOR) echoed the concept in 1997 . </P>

The correct order of the emergency chain of survival is