2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 2. Current status of cardiac arrest and the chain of survival

¹연세대학교 원주의과대학 응급의학교실
²서울대학교 의과대학 응급의학교실
³인하대학교 의과대학 응급의학교실
⁴한림대학교 의과대학 응급의학교실
⁵인제대학교 상계백병원 소아청소년과
⁶서울대학교 의과대학 소아과학교실
⁷서울아산병원 디자인콘텐츠팀
⁸가톨릭대학교 의과대학 응급의학교실
⁹가톨릭대학교 성빈센트병원 응급의학과
¹⁰아주대학교 의과대학 응급의학교실
¹¹남서울대학교 응급구조학과
¹²연세대학교 의과대학 응급의학교실

Sung Oh Hwang¹

, Kyoung-Chul Cha¹

, Jisook Lee¹⁰

Correspondence

Sung Phil Chung ,Tel: 02-2019-3030, Fax: 02-2019-4820, Email: emstar@yuhs.ac,

Received: February 14, 2026; Accepted: April 27, 2026. Published online: June 30, 2026.

ABSTRACT

In Korea, more than 30,000 out-of-hospital cardiac arrests (OHCAs) occur each year, and the survival rate remains below 10%. Because OHCA is difficult to predict and typically occurs outside medical facilities, effective management requires not only healthcare professionals but also laypersons, including bystanders and first responders. Survival depends on an uninterrupted and efficient sequence of time-critical actions: early recognition of cardiac arrest and activation of emergency services; prompt bystander cardiopulmonary resuscitation (CPR); use of an automated external defibrillator (AED) for shockable rhythms; onscene and in-hospital advanced life support with comprehensive post?cardiac arrest care; and systematic assessment of neurologic and functional outcomes followed by rehabilitation and recovery. The chain of survival describes these essential steps required to maximize survival after cardiac arrest and comprises five links: (1) early recognition and call for help; (2) immediate bystander CPR; (3) early defibrillation with an AED; (4) advanced life support and post-cardiac arrest care; and (5) rehabilitation and recovery for survivors. The cardiac arrest survival environment represents a societal infrastructure that sustains and optimizes both medical and nonmedical factors across prevention, treatment, and rehabilitation to reduce mortality. Establishing such an environment requires each community to develop integrated medical systems for prevention, treatment, rehabilitation, and recovery, alongside nonmedical strategies, including public awareness initiatives, widespread CPR education and bystander participation, AED dissemination, and coordinated community responsiveness of the emergency medical system.

Key words: Chain of survival; Cardiopulmonary resuscitation; Heart arrest