b'Case DefinitionCARES captures data on all non-traumatic out-of-hospital cardiac arrests where resuscitation is attempted by a 911 Responder (CPR and/or defibrillation). This also includes patients that receive an AED shock by a bystander prior to the arrival of 911 Responders. Inclusion and exclusion criteria are described below (Tables 1 and 2).Table 1. CARES inclusion criteria (all of the following) Patients of all ages who experience a non-traumatic, out-of-hospital cardiac arrest. Patients who are pulseless on arrival of 911 Responder; OR Patients who become pulseless in the presence of 911 Responder; OR Patients who have a pulse on arrival of EMS, where a successful attempt at defibrillation was undertaken by a bystander prior to arrival of 911 Responder.Table 2. CARES exclusion criteria (any of the following) Unworked/untreated cardiac arrests, to include codes that are terminated immediately upon arrival of EMS because the patient is not a viable candidate for resuscitation due to: Injuries incompatible with life.Signs of decomposition. The presence of rigor mortis or lividity.Presence of a valid DNR. Stillborn neonates/perinatal newborns, born without signs of life. Private EMS transport that did not involve 911 dispatch. Cardiac arrest of clear and obvious traumatic etiology. Bystander suspected cardiac arrest, where ROSC was achieved without the need for defibrillation or 911 Responder CPR.Data Collection & ElementsData collection within CARES is based on the Utstein- The CARES form also includes a number of optional style definitionsa standardized template of uniformtime elements, including estimated time of arrest, reporting guidelines for clinical variables and patientinitial CPR, defibrillatory shock, sustained ROSC, and outcomes that was developed by internationaltermination of resuscitative efforts. Supplemental data resuscitation experts. 1,2The CARES web-based softwareelements collected from 911 call centers include the time (https://mycares.net), links three sources to describethat the call was received, the time of dispatch for both each OHCA event: 1) 911 call center data, 2) EMS data,first responder and EMS providers, and arrival time at and 3) hospital data. Data can be submitted in two ways:the scene.using a data-entry form on the CARES website, or viaData elements collected from receiving hospitals include daily upload from an agencys electronic patient-careemergency department outcome, provision of therapeutic record (ePCR) system. Access to the CARES website ishypothermia/TTM, hospital outcome, discharge restricted to authorized users, who are prohibited fromlocation, and neurological outcome at discharge (using viewing data from another agency or hospital. the Cerebral Performance Categories [CPC] Scale). Data elements collected from EMS providersReceiving facilities may also complete optional elements include demographics (i.e. name, age, date of birth,outlining hospital procedures, including coronary incident address, gender, and race/ethnicity), arrestangiography, CABG, and stent or ICD placement.circumstances (i.e. location type of arrest, witness status,CARES required data fields are harmonized with and presumed etiology), and resuscitation-specific dataNHTSAs National EMS Information System (NEMSIS) (i.e. information regarding CPR initiation and/or AEDversion 3.5. Future efforts will focus on alignment of application, defibrillation, initial arrest rhythm, return ofCARES supplemental data elements with NEMSIS fields.spontaneous circulation [ROSC], field hypothermia, and pre-hospital survival status). EMS providers are also ableThe CARES dataset is geocoded on an annual basis to enter a number of optional elements, which furtherand linked to a number of census-tract level variables detail arrest interventions (i.e. usage of mechanical CPRincluding: median household income, median age, device, ITD, 12 Lead, automated CPR feedback device,race and ethnicity, unemployment rate, poverty status, and advanced airway; administration of drugs; andurbanicity, and educational attainment. diagnosis of STEMI).15'