b'CARES Annual Report 2019 | 7A Year in ReviewDear CARES Community, 2020 jolted our consciousness to consider how front-line medical providers help patients each day, often under difficult circumstances. COVID-19 highlights the fragility of life, reminds us of our own mortality and provides us with numerous examples of the dedication, sacrifice and commitment that EMS and hospital providers have for patients globally. We are honored to work with you and pray for your safety, health and well-being during this pandemic.We are reminded of the importance of public health surveillance activities now more than ever and the need for having accurate data to understand today in an effort to improve tomorrow. CARES has made significant advances towards this goal during the past year, including participation of six additional states and strengthening collaboration nationally. A public-private partnership was announced last October between CARES, American Red Cross, American Heart Association and the Department of Health and Human Services (HHS). The additional support from the three entities will go toward HHSs national goal of expanding CARES to all 50 states in the U.S. and the District of Columbia, and, through data-driven improvements in treatment, double the survival rate from witnessed out-of-hospital cardiac arrests within five years (2021-2026). This effort has been endorsed by Admiral Brett Giroir, Assistant Secretary for Health for HHS. This collaboration will help communities measure standard OHCA outcomes and perform local improvement activities to increase survival nationally. We also commit to dramatically reducing the longstanding racial and ethnic disparities in bystander CPR performance and survival following OHCA, stated Admiral Giroir in a recent press release. In 2019, CARES essential data fields were harmonized with NHTSAs (National Highway Traffic and Safety Administration) NEMSIS (National EMS Information Elements) version 3.5. This coordinated effort ensures uniform data fields for out-of-hospital cardiac arrests for EMS providers nationally and minimizes the data burden to participate in CARES. Future efforts will focus on alignment of CARES supplemental data fields with NEMSIS version 3.6. We wish to thank NHTSA/NEMSIS staff and the CARES Advisory Committee in reaching consensus.Drowning is a leading cause of preventable death; however, there is a lack of quality data that providers and policymakers can use to improve outcomes. In 2015, the International Liaison Committee on Resuscitation (ILCOR) issued an Advisory Statement on Utstein-style Recommended Guidelines of Data from Drowning Related Resuscitation. This past year, CARES developed a drowning module in response to a request from members of the American Red Cross Scientific Advisory Council - Aquatics Subcommittee to address the absence of national drowning resuscitation data. The additional 7 drowning data elements were developed, balancing data benefit and burden. The goal is to improve national surveillance and our understanding of these events to develop effective prevention strategies to save lives. Please see the article by Chief John Titchen (page 19) on how the module will be used in Hawaii, where drowning is the number one cause of death in tourists.We recognize that the COVID-19 pandemic will continue to create challenges this year in the pre-hospital and hospital settings for both patients and providers and applaud those working on the health care front lines. We will continue to work with participating communities and states and are excited about expanding CARES nationally in collaboration with our partners, in the near future. Please be safe and stay healthy. Respectfully, Bryan McNally, MD, MPH Executive Director CARES Professor of Emergency Medicine Emory University School of Medicine Rollins School of Public Health Atlanta, Georgia USA'