Chain of Survival: Quality and Safety in Critical Care

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Malee Kumkong


Quality and safety are crucial goals for critical care. Increased rate of mortality is associated with untreated condition. Continuous and seamless treatment process is the cornerstone of chain of survival particularly, caring for patients with in-hospital cardicac arrest. Chain of survival is a five-step process with two phases for providing treatment. Phase 1 is prevention and emergency response which is management of cardiac arrest prevention using chain of prevention as a treatment guidline. This phase includes (1) staff education team learning in detection of changes in sings and symptoms, first aid, and call for help, (2) monitoring the symptoms and vital signs monitoring with proper and complete frequency of evaluation and interpretation. (3) recognition of victims’ hazard based on signals or critical waning signs or early warning scores that is used as a tool to monitor symptoms and classify victims’ severity which leads medical decision. (4) the call for help by reporting and calling more experienced and trained team to help victims with worse symptoms with using effective and international communication system with SBAR. and (5) the responsiveness with rapid and timely consultation and response of team. Phase 2 is effective advanced life support and post-cardiac arrest care by adopting immediate life support using prepared medical equipments with early detection and correction to maintain blood circulation, thereby resulting in the quality of survival    


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