الفهرس 
OUT-OF-HOSPITAL CARDIACOnly 14 pages are availabe for public view
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Abstract
Introduction: Cardiac arrest is defined as the absence of mechanical cardiac activity determined by the absence of pulse and normal breathing. Out-of-hospital cardiac arrest (OHCA) affects 235 000 to 325 000 people in the United States, 275 000 in Europe, and 105 000 in Japan each year. However, the survival rate after OHCA, especially without neurological impairment, remains low and the burden of the disease is high.
Aim of the essay: The aim of the essay is to study the implementation of the fifth link of chain of survival concept and its effectiveness on neurological outcome and long-term survival in out-of-hospital cardiac arrest (OHCA).
Summary: The incidence of Emergency Medical Services (EMS)-assessed Out-of-hospital cardiac arrest (OHCA) reported by the Resuscitation Outcome Consortium (ROC) Investigators (ROC Investigators, November 23, 2015) to the total population of the United States suggests that each year, 110.8 individuals per 100 000 population or 356 500 people of any age or 347 000 adults experience EMS-assessed OHCA.
In 2005, the European Resuscitation Council (ERC) revised the final link in the chain of survival concept to a provision for “post-resuscitation care” from “early advanced cardiac life support”. In the 2005 ERC guidelines, the final link is targeted at preserving function, particularly of the brain and heart, and recognizes the importance of restoring quality of life to the cardiac arrest survivor.
Conclusion: Although randomized trials have not yet been performed, providing regional systems of care for post-cardiac arrest care is a reasonable approach. Several large nationwide studies have suggested that the recent improvements in outcome in OHCA patients are associated with the provision of post-cardiac arrest care. Therefore, implementation of the fifth link in the chain of survival in regional systems of care can be associated with significant and important improvements in survival and a favorable neurologic outcome. Therefore, the fifth link is important for achieving the goal of resuscitation.