12 CARES in Action SaveMiHeart in Michigan By Teri Shields, Michigan CARES Coordinator In 2014, Michigan partnered with CARES as a statewide effort to report data on out-of-hospital cardiac arrest. The same year SaveMiHeart1 , a non-profit initiative, was formed to unite the community, dispatch, first responders, EMS and hospital systems to improve cardiac arrest survival. Currently, the CARES registry covers approximately 7.9 million of the total 9.9 million Michigan residents. In 2017, there were 136 Michigan EMS agencies and 110 hospitals actively entering data into CARES. The goal is to have the entire state covered by 2020. CARES has provided valuable data to identify areas for improvement. Recognizing cardiac arrest immediately and acting quickly has been shown to have the greatest impact on survival. SaveMiHeart aims to increase community awareness and education of sudden cardiac arrest and increase bystander compression-only CPR and AED use rates. The bystander CPR rate in Michigan has stayed between 36% and 40% over the past 4 years. The percentage of cardiac arrest patients who had an AED applied prior to EMS arrival was 32% in 2014 and 34.7% in 2017. A current project, Hands on the Heart of Detroit, focuses on populations located in neighborhoods with high incidence of cardiac arrest and low rates of bystander response. Programs such as this working together with community, faith-based and school organizations will help create measurable change in improving survival. SaveMiHeart has collaborated with the University of Michigan athletics program to provide CPR and AED training during football pregame tailgating and also shows a PSA video 2 in the stadium to over 100,000 spectators. The fun yet educational video has gained popularity and has been shown at other sporting events throughout the year. CARES has allowed Michigan communities, which range from remote rural to suburban and urban populations, to address areas for improvement by providing a user-friendly tool to measure performance and provide meaningful feedback to continually improve their system of care. SaveMiHeart works with EMS agencies to recognize and reunite survivors with their rescuers. Bystander intervention along with an excellent system of care often means the difference between a life SAVED and one lost. Utilizing CARES as a strategy to accomplish the mission of SaveMiHeart to double survival in our state by 2020 has already helped save additional lives. Incident Command for Cardiac Arrest in Chicago By Dr. Joseph Weber, EMS Medical Director, Chicago EMS System Until recently, Chicago has been known as a city with one of the lowest published cardiac arrest survival rates and therefore, a place you did not want to have a cardiac arrest. But in 2011, the Chicago EMS System and the Chicago Fire Department (CFD) decided to take on out-of-hospital cardiac arrest. This new quality assurance initiative started with a focus on CFD and their EMS response to cardiac arrest. The department created new protocols that focused on high quality on scene resuscitation with team-based care. However, in an EMS system the size of Chicago with more than 1,500 paramedics and 3,000 EMTs, protocol change is not easily achieved. The CFD simulation training center was central to their success. They took on the herculean task of putting all of their providers through a hands-on simulation based course in their new approach to cardiac arrest, termed “Incident Command for Cardiac Arrest”. The training continues today for all new providers as well as refresher courses for those who have previously completed the training. With their new protocols on the streets, CFD needed data to see if their initiatives were improving survival. In 2013, they joined a multi-institutional collaborative group from the state of Illinois, Illinois Heart Rescue, that applied for and was awarded the Medtronic Foundation Heart Rescue Grant. As part of this grant, CFD began using the CARES Registry to collect outcome data on all of their cardiac arrest patients. In September of 2013, the first data reports from the CARES 1 https://www.savemiheart.org/about 2 https://www.youtube.com/watch?v=QLyxKFSwX5M