Latest News

Global Resuscitation Alliance Webinar - May 27

The mission of the Global Resuscitation Alliance is to advance the dissemination and implementation of best-practices in resuscitation. To help you continue learning during these challenging times, they are hosting a series of free webinars. Tune in to their first event and take advantage of the opportunity to gain resuscitation insights from key experts. --Explore new science and strategies for effective implementation of guidelines --Learn about late-breaking science from experts --Gain valuable knowledge on best practices from different countries and regions Thursday, May 27, 2021; 3pm Eastern Time To register:

Governor Stitt Signs Bill To Provide T-CPR Training For 911 Operators in Oklahoma

Governor Kevin Stitt of Oklahoma signed a bill into law last week that could increase survival chances for those suffering a cardiac arrest. The bill includes high-quality telecommunication training for 911 operators in the event that the person on the other line is trying to help someone that has gone into cardiac arrest with no medical professionals around to help.

Please see link below:

Effect of Machine Learning on Dispatcher Recognition of Out-of-Hospital Cardiac Arrest During Calls to Emergency Medical Services

?These findings suggest that while a machine learning model recognized a significantly greater number of out-of-hospital cardiac arrests than dispatchers alone, this did not translate into improved cardiac arrest recognition by dispatchers."

Please see the following link:

Optimal Level of Training for Emergency Call-Takers: Ensuring the Best Outcome in Cardiac Arrest

Emergency medical services (EMS) systems play an important role in bridging the gap between the citizens and the provision of appropriate emergency and critical care treatment. Calling a public emergency helpline such as 911 offers one of the first contacts with the receiving of emergency medical assistance. Call-takers in most of these centers are trained to offer citizen instruction in the application of cardiopulmonary resuscitation (CPR). The question remains as to the appropriate amount of medical training that these call-takers should receive.

Please see the following link:

Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Card

In this cohort study that used a time-dependent propensity score?matched analysis including 27 705 patients with out-of-hospital cardiac arrest, intra-arrest transport compared with continued on-scene resuscitation had a probability of survival to hospital discharge of 4.0% vs 8.5%, a difference that was statistically significant.

Please see the following link:

Association Between Patient Race And Staff Resuscitation Efforts After Cardiac Arrest In Outpatient Dialysis Clinics: A Study From The CARES Team

Cardiac arrest is the leading cause of death among patients receiving hemodialysis. Despite guidelines recommending CPR training and AED presence in dialysis clinics, rates of CPR and AED use by dialysis staff are suboptimal. Given that racial disparities exist in bystander CPR administration in non-healthcare settings, we examined the relationship between patient race/ethnicity and staff-initiated CPR and AED application within dialysis clinics.

Please see the following link:

Overdose Masquerading as Sudden Cardiac Death: From the POstmortem Systematic InvesTigation of Sudden Cardiac Death Study

Although many overdose cases are obvious, with history of ingestion or evidence of drug use at the scene, others may present occultly as out-of-hospital cardiac arrest (OHCA), with an emergency medical services (EMS) primary impression of cardiac arrest but no history or overt signs of overdose. Recognition and characterization of these occult overdose OHCA deaths are critical for accurate estimates of overdose mortality and to inform public health measures, especially in the context of the ongoing opioid epidemic

Please see the following link:

Evidence-Based Crisis Standards Of Care For Out-Of-Hospital Cardiac Arrests In A Pandemic

Pandemics such as COVID-19 can lead to severe shortages in healthcare resources, requiring the development of evidence-based Crisis Standard of Care (CSC) protocols. Our primary objective was to evaluate candidate OHCA CSC protocols involving known predictors of survival and identify the protocol that results in the smallest resource burden, as measured by the number of hospitalizations required per favorable OHCA outcome achieved. Our secondary objective was to describe the effects of the CSC protocols in terms of health outcomes and other measures of resource burden.

Please see the following link:

Assessment of Community Interventions for Bystander CPR in OHCA

This systematic review and meta-analysis of 9 studies including 21 266 out-of-hospital cardiac arrests found that community interventions were associated with better out-of-hospital cardiac arrest survival and bystander cardiopulmonary resuscitation rates; the difference for both outcomes was approximately 1.3-fold with vs without community interventions. The results of this study suggest that community interventions may be associated with better rates of bystander cardiopulmonary resuscitation and patient survival after out-of-hospital cardiac arrest.

Please click on link:

Characteristics Associated With Out-of-Hospital Cardiac Arrests and Resuscitations During the Novel Coronavirus Disease 2019 Pandemic in New York City

In this population-based cross-sectional study of 5325 patients with out-of-hospital cardiac arrests, the number undergoing resuscitation was 3-fold higher during the 2020 COVID-19 period compared with during the comparison period in 2019.

Please click on link:

Out-Of-Hospital Cardiac Arrest Across The World: First Report From The International Liaison Committee On Resuscitation (ILCOR)

Since development of the Utstein style recommendations for the uniform reporting of cardiac arrest, increasing numbers of national and regional out-of-hospital cardiac arrest (OHCA) registries have been established worldwide. The International Liaison Committee on Resuscitation (ILCOR) created the Research and Registries Working Group and aimed to systematically report data collected from these registries.

Please click on link:

Care and Outcomes of Urban and Non-urban Out-of-Hospital Cardiac Arrest Patients during the HeartRescue Project in Washington State and North Carolina

We examined overall and temporal differences in out-of-hospital cardiac arrest (OHCA) care and outcomes by urban versus non-urban setting separately for North Carolina (NC) and Washington State (WA) during HeartRescue initiatives and associations of urban/non-urban settings with outcome by state.

Please click on this link to read article:

Out-of-Hospital Cardiac Arrest During The COVID-19 Outbreak in Italy

Despite the risk of rapid respiratory failure and cardiac complications due to COVID-19, it is unclear whether there is an association between COVID-19 and out-of-hospital cardiac arrest. The Lombardy region of Italy was among the first areas to have an outbreak of COVID-19 outside China, and the first case there was diagnosed on February 20, 2020, in Lodi Province.

Please click on the link:

2019 CARES National Reports & Video

The 2019 National Reports are now posted on the CARES website under the Data tab. We'd also like to share a brief 2-minute video that summarizes last year's national metrics. Please click on the links below.

We sincerely appreciate your participation in CARES and your dedication to saving lives from out-of-hospital cardiac arrest!

-The CARES Team

2019 CARES National Reports

2019 National Metrics Video

Urgent Guidance, Approach To Identify Patients At Risk Of Drug-Induced Sudden Cardiac Death From Use Of Off-Label COVID-19 Treatments

Some of the medications being used to treat COVID-19 are known to cause drug-induced prolongation of the QTc of some people. Patients with a dangerously prolonged QTc are at increased risk for potentially life-threatening ventricular rhythm abnormalities that can culminate in sudden cardiac death. A new study details more information about potential dangers and the application of QTc monitoring to guide treatment when using drugs that can cause heart rhythm changes.

Please click on the link:

AHA News: Race, Income in Neighborhoods Tied to Cardiac Arrest Survival

Socioeconomics might impact the chance of surviving a cardiac arrest, suggests a new study that found survival rates are lower in heavily black than in heavily white neighborhoods, and in low- and middle-income areas compared with wealthy ones.

Please click on the link:

Save More Lives Challenge

The Save More Lives Challenge asks the public to consider SCA and how to respond if it occurred in their presence. People are encouraged to watch a two-minute CALL. PUSH. SHOCK training video and partake in the campaign by practicing the learned techniques and using the hashtag #SaveMoreLives. The challenge is also designed to ignite action for cardiac arrest measures from change-makers in the legislature by raising awareness of Sudden Cardiac Arrest through online petitions that highlight programs and techniques that could save lives.

Save More Lives Challenge

Call.Push.Shock Training Video

Sudden Cardiac Arrest Survival in HEARTSafe Communities

The HEARTSafe Communities program promotes community efforts to improve systems for treating sudden cardiac arrest (SCA). The study hypothesis was that the rates of SCA survival to admission, discharge, and discharge with CPC score 1 or 2 are higher in HEARTSafe-designated communities than non-designated communities in Connecticut, USA. Secondary outcomes included bystander CPR and AED application.

Please see article here:

NIH Funding For Cardiac Arrest Research Low Compared To Funding For Other Leading Causes Of Death, Disability

The National Institutes of Health (NIH) invests less money in cardiac arrest research compared to other leading causes of death and disability in the United States, according to preliminary research to be presented at the American Heart Association's Resuscitation Science Symposium 2019, November 16-17, in Philadelphia.

Please see article here:

To Increase Survival Rates Nationally, Cardiac Arrest Registry Expands Reach Through Public-Private Collaboration

CARES is expanding its reach, with a goal of including all 50 U.S. states and the District of Columbia in its registry and doubling the survival rate from witnessed out-of-hospital cardiac arrests within five years, thanks to support from a collaborative group.

Please see the article here:

Kentucky Office of Rural Health Awarded Grant to Combat Sudden Cardiac Arrest Survival Rates in Rural Counties

The Kentucky Office of Rural Health (KORH) has been awarded a three-year, $750,000 grant from the Health Resources and Services Administration's Federal Office of Rural Health Policy to improve out-of-hospital sudden cardiac arrest survival rates among residents of rural counties served by the state's 27 designated critical access hospitals. The University of Kentucky Center of Excellence in Rural Health, in Hazard, serves as the federally-designated KORH.

Please see the article here:

EMS, Quality Improvement Programs

Quality Improvement (QI) is the intentional process of making system-level changes in clinical processes with a continuous reassessment to improve the delivery of a product. In Emergency Medical Services, this product is essentially the delivery of high-quality prehospital care.

Please see the following link:

Can't Stop Compressing

EMS agencies across the country rose to the challenge, using 110-bpm songs to teach bystanders how to do CPR and maintain the ideal rate for chest compressions. From "Baby Shark" to the "Rocky" theme song, every music video offered potentially lifesaving information in a fun and entertaining way. However, only one video could win the contest portion of the challenge, which ended June 15.

Please see the following link:

Bystanders Who Perform CPR Exponentially Increases Survival Rates - One Atlanta Man Knows

A neighbor's Nest security camera records Matthew Jadlocki as he leaves for a run through the Morningside neighborhood. Minutes after this image was captured, the 36-year-old teacher went into cardiac arrest. The security camera footage helped police and Jadlocki's family trace him to Emory University Hospital, where he'd been admitted as a "John Doe".

Please see the following link:

Closing In On A Killer

In the hunt to stop America's most deadly killer, a formidable citizen squad is gaining more recruits and more ground than ever. Their efforts have propelled the survival rate for people who suffer a cardiac event in The Villages to a stunning 40% more than six times better than the national average of 6%, the Daily Sun found during a yearlong investigation of cities with populations of 100,000.

Please see the following link:

Why Cardiac Arrest Is More Likely To Kill Women Than Men, And What We're Going To Do About It

If you were walking down the street and a man fell to the pavement clutching his chest, would you know what to do? According to a recent study, of 19,331 out-of-hospital cardiac arrests, there's a 45 percent chance that someone would rush forward to give the man the CPR he needs.

Please read the article here:

Out-Of-Hospital Cardiac Arrest Third Leading Cause Of Disease-Related Health Loss

Out-of-hospital cardiac arrest was the third leading cause of "health loss due to disease" in the United States behind ischemic heart disease and low back/neck pain in 2016, according to new research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

Please read the article here:

CPR Increases Survival But Is Underused By Dialysis Staff, Efforts Vary Among Clinics

Odds for survival were increased when dialysis staff initiated CPR before the arrival of EMS but the method was not used in approximately 20% of cardiac arrest events, with use in clinics based on specific variables, according to a study published in the Journal of the American Society of Nephrology.

Please read the article here:

CHOP Researchers Share New Findings On Pediatric Heart Disease At 2018 AHA Conference

A team of clinician-scientists from the Cardiac Center at Childrens Hospital of Philadelphia (CHOP) recently presented a series of new research findings at the American Heart Association 2018 Scientific Sessions in Chicago. The studies covered a wide range of subjects related to cardiovascular disease in children, including proper CPR procedures, exercise capacity for patients who undergo a Fontan procedure, defibrillator use, and other factors that can influence a patient survival and success after treatment.

Please read the article here:

Thousands More Lives Could Be Saved Each Year If More People Understood Sudden Cardiac Arrest And The Need For Immediate Bystander Intervention

A national study conducted for the Sudden Cardiac Arrest Foundation by StrataVerve found that thousands more lives could be saved if only the public understood the critical nature of sudden cardiac arrest and the need for immediate bystander intervention. When exposed to a simple definition of SCA, the likelihood to give CPR or apply an AED increases significantly.

Please read the article here:

Cardiac Arrest Survival Higher In States With Required High School CPR Training

Required CPR education in high school may lead to higher bystander CPR and cardiac arrest survival rates, according to preliminary research to be presented in Chicago at the American Heart Association's Resuscitation Science Symposium 2018 - an international conference highlighting the best in cardiovascular resuscitation research.

Please read the article here:

Automated External Defibrillator Application Before EMS Arrival in Pediatric Cardiac Arrests

Little is known about the predictors of pre-emergency medical service (EMS) automated external defibrillator (AED) application in pediatric out-of-hospital cardiac arrests. We sought to determine patient- and neighborhood-level characteristics associated with pre-EMS AED application in the pediatric population.

Please read the article here:

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest

Concern about the use of epinephrine as a treatment for out-of-hospital cardiac arrest led the International Liaison Committee on Resuscitation to call for a placebo-controlled trial to determine whether the use of epinephrine is safe and effective in such patients.

Please read the article here:

The Evolution Of MEDIC, Charlotte, N.C.'s High-Performing EMS Agency

Although the new headquarters is impressive, it really stands as a symbol of the hard work achieved by the organization people over the last two decades, says Joe Penner, executive director of Medic, whose teams serve all 544 square miles of Mecklenburg County, North Carolina, including the booming city of Charlotte.

Please read the article here

Advocating for Life Support Training of Children, Parents, Caregivers, School Personnel, and the Public

Pediatric cardiac arrest in the out-of-hospital setting is a traumatic event for family, friends, caregivers, classmates, and school personnel. Immediate bystander cardiopulmonary resuscitation and the use of automatic external defibrillators have been shown to improve survival in adults. There is some evidence to show improved survival in children who receive immediate bystander cardiopulmonary resuscitation.

Please read the article here

Emory University, Grady Hospital Examine Treatments For Cardiac Arrest

Emory University and Grady Memorial Hospital in Atlanta, Georgia, recently began conducting clinical trials to examine the best way to care for people who have suffered from cardiac arrest. Specifically, the two entities will focus on methods of care for people who have had an out-of-hospital cardiac arrest, are resuscitated, and transported to the Grady Emergency Department by ambulance.

Please read the article here

Why Ambulances Arent Rushing to the Hospital for Cardiac Arrest

In Western New York, the region's largest emergency medical service provider, AMR, is trying to standardize a new approach, bucking old habits and conventional wisdom. The message now to medical personnel and the public is to stay on the scene and focus on high-quality CPR. The early results are promising.

Please read the article here

Do You Have 60 Seconds? D.C. Want to Teach You CPR

More people die from sudden cardiac arrest each year in the U.S. than die from breast cancer, lung cancer and diabetes combined. In D.C., more than 500 people collapse from cardiac arrest every year. The rate of survival in the District used to be among the lowest in the country, but in the last two years there has been a push by the city to prepare bystanders to save lives.

Please read the article here:

Men More Likely To Receive Bystander CPR In Public Than Women

Men are more likely to receive bystander CPR in public locations compared to women, and they are more likely to survive after the life-saving measure, according to preliminary research presented at the American Heart Associations Scientific Sessions 2017, a premier global exchange of the latest advances in cardiovascular science for researchers and clinicians.

Please read the article here:

ReSS and ECCU abstracts/presentations

ReSuscitation Science Symposium (ReSS) Scientific Sessions 2017 abstracts:
Race/Ethnicity and Socioeconomic Factors are Associated with Bystander CPR in Pediatric Out of Hospital Cardiac Arrest in the United States: A Study from the Cardiac Arrest Registry to Enhance Survival (CARES)
Dickinson W. Richards Memorial Lecture, Monday, November 13th
Naim MY, Griffis HM, Burke RV, McNally BF, Song L, Berg RA, Nadkarni VM, Vellano K, Markenson D, Bradley RN, Rossano JW
Neighborhood Characteristics, Bystander Automated External Defibrillator Use, and Patient Outcomes in Public Out-of-Hospital Cardiac Arrest
Andersen LW, Holmberg M, Granfeldt A, Løfgren B, Vellano K, McNally BF, Siegerink B, Kurth T, Donnino M

Association of Demographic and Geospatial Factors with the Provision of Bystander CPR Following Out-of-Hospital Cardiac Arrest
2017 Young Investigator Award
Buckler DG, Grossestreuer AV, Karp D, Balian S, Carr BG, Wiebe DJ, Abella BS
Cardiac Arrest Risk Standardization in Pennsylvania Using Administrative Data Compared to Registry Data
Grossestreuer AV, Carr BG, Buckler DG, Karp D, Abella BS, Donnino MW, Gaieski DF, Wiebe DJ
Post Admission Variability in OHCA Survival Outcomes in Pennsylvania
Balian S, Buckler DG, Bhardwaj A, Abella BS

Emergency Cardiovascular Care Update (ECCU) presentations:

Success stories - Using Data to Save Lives
Lucinda Hodgson
Wednesday, December 6

Challenges and Progress for Community-Based Resuscitation: Examples from HeartRescue Consortium
Tom Rea
Wednesday, December 6

If at First You Dont Succeed...Lessons Learned by the Resuscitation Academy and Global Resuscitation Alliance for the Real World
Tom Rea, Freddy Lipper, Teri Campbell, Terry Vanden Hoek
Thursday, December 7
Plenary Session; 8:25-9:15am
Breakout Session; 10:35-11:25am

Making the Grade: Hospital CARES Report Cards
Adam Rodos, Teri Campbell
Thursday, December 7

CARES Database & Improving Survival
Joe Rossano
Thursday, December 7

Cheating Death: Improving Statewide Cardiac Survival in Maryland Using CARES
Kevin Seaman
Friday, December 8

ReSuscitation Science Symposium Scientific Sessions 2017, November 11 -15, 2017

Emergency Cardiovascular Care Update (ECCU), December 5 - 8, 2017

Saving Hearts in the Heartland

When a group of Michigan clinicians and researchers set a goal of doubling the states sudden cardiac arrest (SCA) survival rate over the next three years, they knew it would take a team of dedicated, enthusiastic individuals and the help of others like them around the country who would already found ways to improve cardiac arrest systems of care.

Please read the article here:

A Comparison Of Pediatric Airway Management Techniques During Out-Of-Hospital Cardiac Arrest Using The CARES Database.

OBJECTIVE: To compare odds of survival to hospital discharge among pediatric out-of-hospital cardiac arrest (OHCA) patients receiving either bag-valve-mask ventilation (BVM), supraglottic airway (SGA) or endotracheal intubation (ETI), after adjusting for the propensity to receive a given airway intervention.

Please read the article here:

HeartRescue United States Expands Effort to Reduce Deaths from Sudden Cardiac Arrest

More than 300,000 people experience sudden cardiac arrest (SCA) each year in the United States. Despite a growing body of evidence of effective ways to respond to and treat SCA, survival rates for people who suffer cardiac arrest outside of the hospital is low, estimated at between 7-10%, and even lower in many communities.

Please read the article here:

When to Say When? Timing of DNR After Cardiac Arrest Varies Widely Among US Hospitals

Despite current guidelines that recommend waiting 48-72 hours after in-hospital cardiac arrest to assess patient prognosis, registry data show marked variation among US hospitals as to when survivors of cardiac arrest are placed on Do Not Resuscitate (DNR) orders, with up to 40% of patients being made DNR within 12 hours.

Please read the article here:

This Md. Moms Son Nearly Drowned. Now She Has Made It A Mission To Help People Learn CPR.

A freelance marketing consultant who funds the effort out of her own pocket and with donations, has helped more than a thousand people in Maryland, Virginia and the District learn how to properly perform CPR.

Please read the article here:

Health Insurance Expansion and Incidence of Out‐of‐Hospital Cardiac Arrest: A Pilot Study in a US Metropolitan Community

Health insurance has many benefits including improved financial security, greater access to preventive care, and better self‐perceived health. However, the influence of health insurance on major health outcomes is unclear. Sudden cardiac arrest prevention represents one of the major potential benefits from health insurance, given the large impact of sudden cardiac arrest on premature death and its potential sensitivity to preventive care.

Please read the article here:

Direct Transport to a Percutaneous Cardiac Intervention Center and Outcomes in Patients With Out-of-Hospital Cardiac Arrest

Practice guidelines recommend regional systems of care for out-of-hospital cardiac arrest. However, whether emergency medical services should bypass nonpercutaneous cardiac intervention (non-PCI) facilities and transport out-of-hospital cardiac arrest patients directly to PCI centers despite longer transport time remains unknown.

Please read the article here:

The Cardiac Chain Of Survival

Greetings Youth Caregiver. Your mission, should you choose to accept it, is to be prepared in the event of a cardiac emergency. Sudden Cardiac Arrest is the #1 killer of student athletes and the leading cause of death on school campuses. 1 in 300 youth has an undetected heart condition that puts them at risk. Learning the Cardiac Chain of Survival will make it POSSIBLE for you to protect young hearts. Watch the five steps that can save a life.

Please view the video here:

Out-Of-Hospital Cardiac Arrest Survival In Drug-Related Versus Cardiac Causes In Ontario: A retrospective cohort study

Drug overdose causes approximately 183,000 deaths worldwide annually and 50,000 deaths in Canada and the United States combined. Drug-related deaths are concentrated among young people, leading to a substantial burden of disease and loss of potential life years. Understanding the epidemiology, patterns of care, and prognosis of drug-related prehospital emergencies may lead to improved outcomes.

Read the article here:

Priority Dispatch, PulsePoint Team Up to Help 911 Dispatchers Connect Citizens with AEDs

Priority Dispatch Corp. and the PulsePoint Foundation have announced a global, strategic partnership that will optimize the way emergency medical dispatchers (EMD) pinpoint and communicate the location of AEDs during time-critical cardiac emergencies.

Read the article here:

Cardiac Arrest Patients Do Better If Taken Immediately To A Specialist Heart Center

People who suffer cardiac arrest outside of hospital have a better chance of survival if they are taken immediately to a specialist heart center rather than to the nearest general hospital, according to new research. The study found that distance needed to travel to a specialist heart center was not linked to better or worse risk of death.

Read the article here:

Cardiac Arrest Infographic

The National Center for Chronic Disease Prevention & Health Promotion, Division for Heart Disease and Stroke Prevention, at the Centers for Disease Control and Prevention has developed an infographic on the public health importance of cardiac arrest.

Please feel free to circulate this infographic:

For more information on heart disease, please go to the CDC's Division for Heart Disease and Stroke Prevention website:


We will be hosting a CARES/PAROS (Pan-Asian Resuscitation Outcomes Study) meeting at the 2017 NAEMSP conference in New Orleans, LA on Tuesday, January 24th from 7:30-8:30am. The meeting will be held at the Hyatt Regency New Orleans in the "Celestin G" Room.

2017 NAEMSP conference in New Orleans, LA

Association Of Bystander CPR With Survival After Pediatric OHCA

A peer-reviewed article utilizing CARES data entitled "Association of Bystander Cardiopulmonary Resuscitation With Overall and Neurologically Favorable Survival After Pediatric Out-of-Hospital Cardiac Arrest in the United States" was published today in JAMA Pediatrics. Dr. Maryam Naim was awarded the 2015 "Cardiovascular Disease in the Young Outstanding Research Award in Pediatric Cardiology" for this work. The abstract and PubMed link can be found below.

Importance:  There are few data on the prevalence or outcome of bystander cardiopulmonary resuscitation (BCPR) in children 18 years and younger.

Objective:  To characterize BCPR in pediatric out-of-hospital cardiac arrests (OHCAs).

Design, Setting, and Participants:  This analysis of the Cardiac Arrest Registry to Enhance Survival database investigated nontraumatic OHCAs in children 18 years and younger from January 2013 through December 2015.

Exposures:  Bystander CPR, which included conventional CPR and compression-only CPR.

Main Outcomes and Measures:  Overall survival and neurologically favorable survival, defined as a Cerebral Performance Category score of 1 or 2, at the time of hospital discharge.

Results:  Of the 3900 children younger than 18 years with OHCA, 2317 (59.4%) were infants, 2346 (60.2%) were female, and 3595 (92.2%) had nonshockable rhythms. Bystander CPR was performed on 1814 children (46.5%) and was more common for white children (687 of 1221 [56.3%]) compared with African American children (447 of 1134 [39.4%]) and Hispanic children (197 of 455 [43.3%]) (P < .001). Overall survival and neurologically favorable survival were 11.3% (440 of 3900) and 9.1% (354 of 3900), respectively. On multivariable analysis, BCPR was independently associated with improved overall survival (adjusted proportion, 13.2%; 95% CI, 11.81-14.58; adjusted odds ratio, 1.57; 95% CI, 1.25-1.96) and neurologically favorable survival (adjusted proportion, 10.3%; 95% CI, 9.10-11.54; adjusted odds ratio, 1.50; 95% CI, 1.21-1.98) compared with no BCPR (overall survival: adjusted proportion, 9.5%; 95% CI, 8.28-10.69; neurologically favorable survival: adjusted proportion, 7.59%; 95% CI, 6.50-8.68). For those with data on type of BCPR, 697 of 1411 (49.4%) received conventional CPR and 714 of 1411 (50.6%) received compression-only CPR. On multivariable analysis, only conventional CPR (adjusted proportion, 12.89%; 95% CI, 10.69-15.09; adjusted odds ratio, 2.06; 95% CI, 1.51-2.79) was associated with improved neurologically favorable survival compared with no BCPR (adjusted proportion, 9.59%; 95% CI, 6.45-8.61). There was a significant interaction of BCPR with age. Among infants, conventional BCPR was associated with improved overall survival and neurologically favorable survival while compression-only CPR had similar outcomes to no BCPR.

Conclusions and Relevance:  Bystander CPR is associated with improved outcomes in pediatric OHCAs. Improving the provision of BCPR in minority communities and increasing the use of conventional BCPR may improve outcomes for children with OHCA.

PubMed link

NASEMSO Resolution in Support of CARES

CARES presented a registry update to state medical directors, data managers, and electronic Patient Care Record (ePCR) vendor contacts at the National Association of State EMS Officials Conference in Albuquerque, New Mexico on September 19th. An update was provided on current state and site participation, 2016-2017 focus states, ePCR extraction processes, and program collaboration with HeartRescue. As a result of the discussion, NASEMSO membership approved an official resolution supporting and encouraging participation in CARES, which will be very valuable to program recruitment and ePCR vendor engagement. CARES continues to strive towards establishing relationships with stakeholders for expanded state and site participation in the registry.

If you are interested in joining the CARES State network or HeartRescue US Consortium, please contact Monica Rajdev ( or Dr. Thomas Rea (, respectively.

NASEMSO Resolution 2016:

CARES Educational Webinar 2016

We would like to thank Dr. Kruger and Dr. Martin for their recent presentation entitled "Prehospital Cardiac Catheterization Lab Activation for Witnessed Ventricular Fibrillation Cardiac Arrest." The webinar covered the success of the novel system implemented in Lincoln, Nebraska which has since drastically improved their OHCA survival rate. At the end of the webinar the audience asked great questions about the challenges as well as solutions for emulating similar systems in their own communities. 

For those who could not join or are interested in distributing the webinar to their department, please see below for links to the recording and slide deck.

The full recording can be accessed at the link below:

The slide deck can be accessed at the link below:

ReSS Travel Stipends

The Council on Cardiopulmonary, Critical Care, Perioperative & Resuscitation (3CPR) proudly sponsors Emergency Medical Services Travel Stipends to attend ReSS and/or Scientific Sessions 2016, taking place November 12-16 in New Orleans, Louisiana. The Council invites you to apply by August 10, 2016.

These grants will be awarded to encourage and support the efforts of EMS chiefs, educators and other non-physician EMS leadership and encourage them to participate in council and AHA activities such as the Resuscitation Science Symposium Nov. 12-14.

These stipends provide travel funding to the AHA's Resuscitation Science Symposium (ReSS), as well as complimentary registration for non-physician EMS personnel who have a strong interest in cardiac arrest, CPR and resuscitation care.

Additional information regarding eligibility and the application process can be found at the following link:

Implementation of a Regional Telephone CPR Program and Outcomes After OHCA

We are excited to share a recent publication by Dr. Ben Bobrow et al. that examines the association between Telephone CPR (T-CPR), bystander CPR rates, and OHCA outcomes.

Importance: Bystander cardiopulmonary resuscitation (CPR) significantly improves survival from out-of-hospital cardiac arrest but is provided in less than half of events on average. Telephone CPR (TCPR) can significantly increase bystander CPR rates and improve clinical outcomes.

Objective: To investigate the effect of a TCPR bundle of care on TCPR process measures and outcomes.

Design, Setting, and Participants: A prospective, before-after, observational study of adult patients with out-of-hospital cardiac arrest not receiving bystander CPR before the 9-1-1 call between October 1, 2010, and September 30, 2013.

Interventions: A TCPR program, including guideline-based protocols, telecommunicator training, data collection, and feedback, in 2 regional dispatch centers servicing metropolitan Phoenix, Arizona. Audio recordings of out-of-hospital cardiac arrest calls were audited and linked with emergency medical services and hospital outcome data.

Main Outcomes and Measures: Survival to hospital discharge and functional outcome at hospital discharge.

Results: There were 2334 out-of-hospital cardiac arrests (798 phase 1 [P1] and 1536 phase 2 [P2]) in the study group; 64% (1499) were male, and the median age was 63 years (age range, 9-101 years; interquartile range, 51-75 years). Provision of TCPR increased from 43.5% in P1 to 52.8% in P2 (P < .001), yielding an increase of 9.3% (95% CI, 4.9%-13.8%). The median time to first chest compression decreased from 256 seconds in P1 to 212 seconds in P2 (P < .001). All rhythm survival was significantly higher in P2 (184 of 1536 [12.0%]) compared with P1 (73 of 798 [9.1%]), with an adjusted odds ratio (aOR) of 1.47 (95% CI, 1.08-2.02; P = .02) in a logistic regression model and an adjusted difference in absolute survival rates (adjusted rate difference) of 3.1% (95% CI, 1.5%-4.9%). Survival for patients with a shockable initial rhythm significantly improved in P2 (107 of 306 [35.0%]) compared with P1 (42 of 170 [24.7%]), with an aOR of 1.70 (95% CI, 1.09-2.65; P = .02) and an adjusted rate difference of 9.6% (95% CI, 4.8%-14.4%). The rate of favorable functional outcome was significantly higher in P2 (127 of 1536 [8.3%]; 95% CI, 6.9%-9.8%) than in P1 (45 of 798 [5.6%]; 95% CI, 4.1%-7.5%), with an aOR of 1.68 (95% CI, 1.13-2.48; P = .01) and an adjusted rate difference of 2.7% (95% CI, 1.3%-4.4%).

Conclusions and Relevance: Implementation of a guideline-based TCPR bundle of care was independently associated with significant improvements in the provision and timeliness of TCPR, survival to hospital discharge, and survival with favorable functional outcome.

The full article can be accessed at the link below:

CARES 2015 Video Metrics

We are excited to present you with a summary video on 2015 metrics. This video includes participation statistics of the program along with National Report summary data. We hope you enjoy this informative presentation. Thank you for your continued CARES support and participation!

CARES 2015 Video Metrics

Statewide Initiatives Improve Outcomes for Patients Who Undergo Cardiac Arrest at Home

According to a study by DCRI (Duke Clinical Research Institute) researchers, North Carolina's statewide effort to promote bystander CPR and first-responder defibrillation improved outcomes for patients who suffered cardiac arrest in their homes. The study was led by Christopher Fordyce, MD and was presented at the annual Scientific Sessions of the American College of Cardiology in Chicago this month.

The full story can be accessed here:

Regional Variation in OHCA Survival in the U.S.

A peer-reviewed article utilizing CARES data entitled "Regional Variation in Out-of-Hospital Cardiac Arrest Survival in the United States" was recently published in Circulation. The abstract and PubMed link can be found below.

Although previous studies have shown marked variation in out-of-hospital cardiac arrest survival across U.S. regions, factors underlying this survival variation remain incompletely explained.
Using data from the Cardiac Arrest Registry to Enhance Survival, we identified 96,662 adult patients with out-of-hospital cardiac in 132 U.S. counties. We used hierarchical regression models to examine county-level variation in rates of survival and survival with functional recovery (defined as Cerebral Performance Category score of 1 or 2) and examined the contribution of demographics, cardiac arrest characteristics, bystander cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, and county-level socio-demographic factors in survival variation across counties. A total of 9317 (9.6%) patients survived to discharge, and 7176 (7.4%) achieved functional recovery. At a county-level, there was marked variation in rates of survival to discharge (range: 3.4%-22.0%, median odds ratio [MOR] 1.40, 95% CI 1.32-1.46) and survival with functional recovery (range: 0.8%-21.0%, MOR 1.53, 95% CI 1.43-1.62). County-level rates of bystander CPR and AED use were positively correlated with both outcomes (P<0.0001 for all). Patient demographic and cardiac arrest characteristics explained 4.8% and 27.7% of the county-level variation in survival, respectively. Additional adjustment of bystander CPR and AED explained 41% of the survival variation, and this increased to 50.4% after adjustment of county-level socio-demographic factors. Similar findings were noted in analyses of survival with functional recovery.
Although out-of-hospital cardiac arrest survival varies significantly across U.S. counties, a substantial proportion of the variation is due to differences in bystander response across communities.

PubMed link:

New Publication in JAHA Utilizing CARES Data

We are excited to share a recent publication by Dr. Paul Chan et al. that utilized CARES data:

"Long-Term Outcomes Among Elderly Survivors of Out-of-Hospital Cardiac Arrest" was published in the Journal of the American Heart Association. This open-access article is accessible at

Thank you for your continued participation in CARES, which helps further knowledge in the field of resuscitative science.

The CARES Team

The article can be accessed here:

Dispatcher Assisted CPR Case

Below is a link to short video which demonstrates how dispatcher assisted CPR positively impacted the life of someone who is having an out of hospital cardiac arrest.

CARES participants can request access to a Dispatcher Assisted CPR module within CARES. For more details please visit the CARES webpage at .

The dispatcher assisted CPR case can be accessed here: Assisted CPR case Edwin Huang NSLD.mp4?dl=0

More information regarding the Dispatcher Assisted CPR module within CARES can be accessed here:

Survival After OHCA in Children

A peer-reviewed article utilizing CARES data entitled "Survival After Out-of-Hospital Cardiac Arrest in Children" was recently published in Journal of the American Heart Association. The abstract and direct access link can be found below.

Background: Little is known about survival after out‐of‐hospital cardiac arrest (OHCA) in children. We examined whether OHCA survival in children differs by age, sex, and race, as well as recent survival trends.
Methods and Results: Within the prospective Cardiac Arrest Registry to Enhance Survival (CARES), we identified children (age <18 years) with an OHCA from October 2005 to December 2013. Survival to hospital discharge by age (categorized as infants [0 to 1 year], younger children [2 to 7 years], older children [8 to 12 years], and teenagers [13 to 17 years]), sex, and race was assessed using modified Poisson regression. Additionally, we assessed whether survival has improved over 3 time periods: 2005-2007, 2008-2010, and 2011-2013. Of 1980 children with an OHCA, 429 (21.7%) were infants, 952 (48.1%) younger children, 276 (13.9%) older children, and 323 (16.3%) teenagers. Fifty‐nine percent of the study population was male and 31.8% of black race. Overall, 162 (8.2%) children survived to hospital discharge. After multivariable adjustment, infants (rate ratio: 0.56; 95% CI: 0.35, 0.90) and younger children (rate ratio: 0.42; 95% CI: 0.27, 0.65) were less likely to survive compared with teenagers. In contrast, there were no differences in survival by sex or race. Finally, there were no temporal trends in survival across the study periods (P=0.21).
Conclusions: In a large, national registry, we found no evidence for racial or sex differences in survival among children with OHCA, but survival was lower in younger age groups. Unlike in adults with OHCA, survival rates in children have not improved in recent years.

Direct Access link:

Early Coronary Angiography and Survival After OHCA

A peer-reviewed article utilizing CARES data entitled "Early Coronary Angiography and Survival After Out-of-Hospital Cardiac Arrest" was recently published in Circulation: Cardiovascular Intervention. The abstract and PubMed link can be found below.

BACKGROUND: Although out-of-hospital cardiac arrest is common because of acute myocardial infarction, it is unknown whether early coronary angiography is associated with improved survival in these patients.
METHODS AND RESULTS: Using data from the Cardiac Arrest Registry to Enhance Survival (CARES), we identified 4029 adult patients admitted to 374 hospitals after successful resuscitation from out-of-hospital cardiac arrest because of ventricular fibrillation, pulseless ventricular tachycardia, or unknown shockable rhythm between January 2010 and December 2013. Early coronary angiography (occurring within one calendar day of cardiac arrest) was performed in 1953 (48.5%) patients, of whom 1253 (64.2%) received coronary revascularization. Patients who underwent early coronary angiography were younger (59.9 versus 62.0 years); more likely to be men (78.1% versus 64.3%), have a witnessed arrest (84.6% versus 77.4%), and have ST-segment-elevation myocardial infarction (32.7% versus 7.9%); and less likely to have known cardiovascular disease (22.8% versus 35.0%), diabetes mellitus (11.0% versus 17.0%), and renal disease (1.8% versus 5.8%; P<0.01 for all comparisons). In analysis of 1312 propensity score-matched pairs, early coronary angiography was associated with higher odds of survival to discharge (odds ratio 1.52 [95% confidence interval 1.28-1.80]; P<0.0001) and survival with favorable neurological outcome (odds ratio 1.47 [95% confidence interval 1.25-1.71]; P<0.0001). Further adjustment for coronary revascularization in our models significantly attenuated both odds ratios, suggesting that revascularization was a key mediator of the survival benefit.
CONCLUSIONS: Among initial survivors of out-of-hospital cardiac arrest caused by VF or pulseless VT, we found early coronary angiography was associated with higher odds of survival to discharge and favorable neurological outcome.

PubMed link:

A corresponding editorial, "How Much is Enough", can be viewed at:

Community and Telephone CPR Workshop at ECCU

Open to call-takers, dispatchers, community CPR trainers, and lay people who
want to learn Telephone-CPR, the pre-conference workshop promises an interactive learning
experience. It provides insight through hands-on CPR practice, 9-1-1 audio
recordings, small-group discussion, and interviews with a survivor, her rescuer
and the call-taker who provided T-CPR instructions.

When: December 7, 2015, 8am-12pm
Where: Manchester Grand Hyatt, San Diego, CA
Who: Helge Myklebust & Tonje Birkenes (Laerdal Medical) and Dr. Ben Bobrow & Micah Panczyk (Arizona Dept. of Health Services)

For more information, please call 602-364-2846.

To register, visit:

IOM Report recommends national registry for OHCA

A new report from the Institute of Medicine (IOM) recommends the establishment of a national registry to track out-of-hospital cardiac arrests (OHCA), while boosting involvement in teaching bystander CPR (cardiopulmonary resuscitation) to communities. The report highlights that "A national responsibility exists to improve the likelihood of survival and favorable neurologic outcomes following a cardiac arrest. This will require immediate changes in cardiac arrest reporting, research, training, and treatment."

The CARES Program is an OHCA registry that has the potential to serve as the recognized registry for the US. CARES, established through a collaborative effort between Emory and the Centers for Disease Control and Prevention (CDC), began in 2004 and has since expanded both nationally and internationally. Currently more than 800 EMS agencies and over 1,300 hospitals in 36 states representing a population footprint of 80 million people participate in the program

"CARES has been able to track improvements in survival and bystander interventions amongst participating communities over time. Our ultimate goal of the program is to serve as a standard platform for quality assurance efforts and improve survival from OHCA," says Bryan McNally, MD, MPH, Executive Director of CARES and Associate Professor of Emergency Medicine at Emory University School of Medicine.

McNally goes on to say, "We are excited to see that the IOM has recognized the importance of having a national registry for OHCA. We believe CARES is well positioned to be the registry for the US as we currently cover approximately 25% of the US population and have approximately 200,000 cardiac arrest events in the registry."

Currently, CARES is funded by the American Red Cross, American Heart Association, Medtronic Foundation and ZOLL Corporation. These partners have supported the concept of CARES as a national registry and emphasized the importance of promoting bystander interventions such as CPR and AED use.

According to McNally, registry data suggests survival rates from OHCA are trending in the right direction. With numerous states participating in CARES, and now the IOM supporting a national registry, we hope this message continues to reach more communities to promote participation in the registry and benefit even more cardiac arrest patients.

The full IOM report can be accessed via the following link:

The CARES commissioned paper on the public health burden of cardiac arrest can be accessed via the following link:

A recording of the report release webcast is available at:


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