Heart Attack In the United States, and especially in big cities and rural areas, tens of thousands of people with hearts that should be good 【51】 to keep them alive die each year for lack of adequate first aid. In New York City, for example, a new study has shown that only one person in 100 outside of hospitals 【52】 after the heart suddenly stops pumping. In contrast, in Seattle, the survival 【53】 after such heart attacks is one in five. "The difference can be traced 【54】 the effectiveness of the chain of survival", Dr. Joseph P. Ornato said. " Each link in the 【55】 must be strong enough for many lives to be 【56】 ". The chain begins with an immediate telephone 【57】 for emergency help and the start within four minutes of the process needed for restarting the 【58】 working, by a family member or bystander (旁观者). It continues with the prompt arrival-------within eight 【59】 ten minutes of a rescuer equipped with a special instrument that can shock the heart back to a normal rhythm. And it ends with the administration (给予, 实施) of advanced (先进) emergency care by nurses to maintain the heart’’s ability to survive until the doctors at the hospitals can take 【60】 When one or more links in this chain fail or function too slowly, the 【61】 of a victim surviving heart attack falls rapidly. Because of widespread weaknesses in the chain of 【62】 , experts in emergency heart care estimate that 20,000 to 80,000 people 【63】 needlessly of heart attack each year, a number comparable to the 55,000 killed annually in automobile 【】 . One expert says, "Sending an emergency vehicle to a heart attack victim, 【65】 the special equipment is like having policemen with guns but no bullets. They may put on a good show, but they lack the weapon needed to get the job done."