b'CARES Annual Report 2020 | 9Prehospital providers may evaluate post-cardiac arrest survivors for many reasons. The root cause of a small house fire or motor vehicle accident may be cognitive dysfunction resulting from previous cardiac arrest. Survivors may struggle with attention, multitasking, or memory and thus have difficulty with everyday activities after discharge. This may not be recognized until people are home from the hospital.Clinicians may see patients in the office or hospital who complain of long-term pain or weakness. They may be unable to return to work, intimacy, or hobbies they once enjoyed. Patients who receive defibrillators may fear being shocked and avoid activities they once enjoyed. This may have long term consequences on prevention of heart disease, stroke, and cancer.It is increasingly recognized that long term anxiety, sadness, and even post-traumatic stress affect both patients, their family members, and rescuers. Difficulty with fear and worry may stem from doing CPRor not performing CPRon a loved one or watching them be resuscitated throughout the system of care.Cardiac arrest affects our families and communities even more than our patients at times. They need resources and support as well. Guidelines, Research Priorities, and Patient Partners In early 2020, the American Heart Association (AHA) published a Scientific Statement on Cardiac Arrest Survivorship2. The statement summarizes the available literature describing the experience of patients and their families and caregivers after cardiac arrest. It also offers a roadmap to recovery that may be used to communicate across hospital systems and specialties. Finally, it identifies promising areas where further research is needed in treatment, rehabilitation, and patient-centered outcomes after sudden cardiac arrest. 2020 AHA Guidelines3 added a 6th link to the Chain of Survival Recovery. This addition acknowledges the need for systematic attention to recovery, rehabilitation, and survivorship plans. Survivorship plans summarize treatments, provide follow up recommendations, and guide recovery expectations such that transitions from hospital to home may be clearer. Adding the Recovery link is the first step in aligning resuscitation treatment recommendations with those for patients surviving stroke, cancer, and other critical illnesses. Survivors and families may be out at our CPR events or scientific meetings sharing their stories. They form peer-to-peer groups online and amplify messages from advocacy organizations. They are increasing partnerships with research groups to provide perspective and feedback. We can provide them the opportunities to add their voices as advocates for CPR training, AED use, and general cardiac arrest awareness. Their experiences will guide our research agenda as we begin to concentrate on what matters most to the survivorship community. 10 Years Later There is still much work to be done to fill treatment gaps and ensure continuity of care after acute hospitalization. But there have been increasing research and international collaborations to address rehabilitation and recovery after cardiac arrest. Guidelines help raise the minimum bar. Nearly 10 years later, I still have vivid memories of that day. I look back with gratitude for all those involved but acknowledge that they struggled in ways I did not. My survival story is OUR story. I recovered and I know that over time, we healed.2Sawyer KN, Camp-Rogers TR, Kotini-Shah P, Del Rios M, Gossip MR, Moitra VK, et al. Sudden Cardiac Arrest Survivorship: A Scientific Statement From the American Heart Association. Circulation. 141(12).3Panchal AR, Bartos JA, Cabaas JG, Donnino MW, Drennan IR, Hirsch KG, et al. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 20:142(16_suppl_2):S366-S468.'