Recognition of warning signs heralding an episode of sudden cardiac arrest or prompt recognition of the episode itself (i.e., unresponsiveness with abnormal breathing or gasping) followed by activation of the EMS system (e.g., by dialing 911).
Initiation of quality CPR (hands-only CPR for adult victims with arrest of presumed cardiac origin) and use of automated external defibrillators (AEDs) by bystanders pending arrival of professional rescuers.
Continuation of CPR by an EMS system capable of delivering hi-quality CPR (e.g., minimally interrupted compressions, enhancement of venous return, physiological feedback, etc.).
Transport to a center capable and committed to manage the post-resuscitation phase having 24/7 capability for providing (1) emergency coronary interventions, (2) therapeutic hypothermia, and (3) a dedicated critical care team able to provide the required environment to help the patient overcome this life-threatening event.
A program of continuous quality improvement based on monitoring outcome and process variables.