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One of the critical interventions for successful resuscitation is early CPR. Starting CPR before the arrival of 
an ambulance significantly increases a patient’s chances of survival. In 2025, bystander CPR was initiated 
on 42.5% of CARES patients. Of note, CARES excludes events witnessed by 911 Responders as well as 
those that occurred in a nursing home or healthcare facility from our bystander CPR rate, as CPR in these 
scenarios is typically performed by trained medical providers.
Bystander CPR provision was strongly correlated with arrest witness status (Figure 13). Bystander CPR 
was initiated after 50.6% of bystander witnessed events, compared to 36.0% of unwitnessed events 
(p<.0001).
Early CPR
Figure 13. Bystander CPR provision by arrest witness status.
Return of spontaneous circulation (ROSC) in the field, survival to hospital admission, and survival to 
hospital discharge were all strongly associated with receipt of bystander CPR (Figure 14). The survival to 
discharge rate for patients receiving bystander CPR (12.8%) was significantly higher (p<.0001) than that of 
patients who did not receive bystander CPR (7.7%).
Figure 14. Unadjusted survival outcomes after bystander CPR.

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