CARES Annual Report 2018 | 5 Introduction EMS treated out-of-hospital cardiac arrest (OHCA) affects more than 240,000 Americans each year and is the third leading cause of disability adjusted life years (DALY) in the United States, behind cardiovascular disease and back pain. Typically, one in ten patients survives to hospital discharge, with 80% having no or moderate neurological disability. Cardiac arrest resuscitation is an important measure of a community’s emergency response readiness. Successful resuscitation requires involvement by a range of individuals including bystanders, emergency medical dispatchers, first responders, paramedics, and hospital providers. Performing bystander CPR can nearly double survival and public access defibrillation results in an almost 50% survival rate for patients presenting in a shockable rhythm. It’s important to remember that these impactful community based interventions happen in advance of 911 responders arriving on the scene. Measurement is key to improving quality of care and patient outcomes. In 2015, the Institute of Medicine released “Strategies to Improve Cardiac Arrest Survival: A Time to Act,” which recommended the establishment of a national cardiac arrest registry to monitor performance in terms of both success and failure, identify problems, and track progress 1 . The Cardiac Arrest Registry to Enhance Survival (CARES) allows communities to benchmark their performance with local, state, or national metrics to better identify opportunities to improve their OHCA care. CARES offers a comprehensive understanding of where arrests are occurring, whether bystanders are providing intervention prior to EMS arrival, EMS and hospital performance, and patient outcomes. This in turn provides the data necessary to make informed decisions and allocate limited resources for maximal community benefit. By creating an easy-to-use and flexible system to collect OHCA data and forming a community to share best practices, CARES has transformed the way EMS agencies are treating cardiac arrest. Participating agencies are able to make decisions in their community based on real-time feedback and analysis, in order to increase survival. We sincerely appreciate the members of the EMS and hospital CARES communities, as well as the sponsors (American Red Cross, American Heart Association, Emory University Woodruff Health Sciences Center, and Stryker) who support our mission to save lives and improve patient care. We are pleased to present the 2018 Annual Report.