title: [The chain of survival].
abstract: Coronary artery disease remains the leading cause of death in Italy as in most developed countries. Many of the victims die from sudden cardiac arrests, most commonly resulting from out-of-hospital ventricular fibrillation. The epidemiological evidence of the high incidence of sudden deaths in the small subgroup of high-risk patients and of the low incidence of events in the large subgroup of low- and intermediate-risk patients which are contributing to most of the deaths has suggested the development of emergency services and to the chain of survival concept. With the development of the automatic external defibrillator, early recognition and treatment of ventricular fibrillation by non-skilled rescuers has significantly improved the outcome of sudden death. Training is essential to provide the numerous skills required for those regularly exposed to resuscitation and also to provide the diffusion of cardiopulmonary resuscitation competence in the general population. This paper reviews the past, present and future development of the epidemiological, organizational, training, and research issues related to the chain of survival.
authors.forename: A
authors.initials: A
authors.lastname: Roghi
mesh_terms: D003327:Coronary Disease / Q000401:mortality* / Q000628:therapy; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D004554:Electric Countershock; D006801:Humans; D007558:Italy / Q000453:epidemiology; D012307:Risk Factors