BLS Chain of Survival 2 — Questions and Answers
Question 1: In the adult out-of-hospital Chain of Survival, which link comes immediately AFTER early CPR?
- Rapid defibrillation (Correct answer)
- Early recognition and activation
- Advanced life support
- Post-cardiac arrest care
Correct answer: Rapid defibrillation
The adult out-of-hospital chain is: recognition/activation → early CPR → rapid defibrillation → advanced life support → post-cardiac arrest care.
Question 2: Why is the 'recognition and activation' link considered the first critical step in the Chain of Survival?
- It starts the 911 dispatch process that brings AED and advanced care (Correct answer)
- It directly restores normal heart rhythm
- It eliminates the need for CPR in most cases
- It replaces the role of trained bystanders
Correct answer: It starts the 911 dispatch process that brings AED and advanced care
Without recognition and activation, no subsequent links in the chain can begin, making it the trigger for all downstream interventions.
Question 3: Which Chain of Survival link is most often performed by bystanders before EMS arrives?
- Early CPR (Correct answer)
- Rapid defibrillation
- Advanced life support
- Post-cardiac arrest care
Correct answer: Early CPR
Bystanders are typically the first on scene and can begin CPR before EMS or AED resources arrive.
Question 4: A patient achieves return of spontaneous circulation (ROSC) after CPR and defibrillation. Which Chain of Survival link is now the priority?
- Post-cardiac arrest care (Correct answer)
- Early CPR
- Rapid defibrillation
- Recognition and activation
Correct answer: Post-cardiac arrest care
Post-cardiac arrest care, including targeted temperature management and hemodynamic support, begins after ROSC is achieved.
Question 5: The in-hospital Chain of Survival differs from the out-of-hospital chain primarily because:
- Surveillance and prevention replace recognition as the first link (Correct answer)
- Defibrillation is not part of the in-hospital chain
- Bystander CPR is not emphasized in hospital settings
- Post-cardiac arrest care is omitted for in-hospital patients
Correct answer: Surveillance and prevention replace recognition as the first link
In-hospital patients are monitored, so the chain begins with surveillance and prevention rather than bystander recognition.
Question 6: During a cardiac arrest, every minute without defibrillation for a shockable rhythm decreases survival by approximately how much?
- 7–10% (Correct answer)
- 1–2%
- 15–20%
- 25–30%
Correct answer: 7–10%
Survival from ventricular fibrillation decreases by approximately 7–10% for every minute that defibrillation is delayed without CPR.
Question 7: Which action best strengthens the 'early CPR' link in a community setting?
- Training more community members in CPR (Correct answer)
- Placing more AEDs in hospitals only
- Reducing ambulance response time targets
- Expanding ICU post-arrest care capacity
Correct answer: Training more community members in CPR
Widespread CPR training increases the pool of bystanders who can immediately begin compressions before EMS arrives.
BLS Chain of Survival 2
In the adult out-of-hospital Chain of Survival, which link comes immediately AFTER early CPR?