b'Case Definition CARES 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 thearrival 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: oInjuries incompatible with life.oSigns of decomposition. oThe presence of rigor mortis or lividity.oPresence 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 & Elements Data collection within CARES is based on the Utstein- CARES form also includes a number of optional time style definitionsa standardized template of uniformelements, including estimated time of arrest, initial CPR, reporting guidelines for clinical variables and patientdefibrillatory shock, sustained ROSC, and termination of outcomes that was developed by internationalresuscitative efforts. Supplemental data elements resuscitation experts1,2. The CARES web-based softwarecollected from 911 call centers include the time that the (https://mycares.net), links three sources to describecall was received, the time of dispatch for both first each OHCA event: 1) 911 call center data, 2) EMS data,responder and EMS providers, and arrival time at the and 3) hospital data. Data can be submitted in twoscene. ways: using a data-entry form on the CARES website, orData elements collected from receiving hospitals include via daily upload from an agencys electronic patient-careemergency department outcome, provision of record (ePCR) system. Access to the CARES website istherapeutic hypothermia/TTM, hospital outcome, restricted to authorized users, who are prohibited fromdischarge location, and neurological outcome at viewing data from another agency or hospital.discharge (using the Cerebral Performance Categories Data elements collected from EMS providers include[CPC] Scale). Receiving facilities may also complete demographics (i.e. name, age, date of birth, incidentoptional elements outlining hospital procedures, address, gender, and race/ethnicity), arrestincluding coronary angiography, CABG, and stent or ICD circumstances (i.e. location type of arrest, witnessplacement. status, and presumed etiology), and resuscitation- CARES required data fields are harmonized with specific data (i.e. information regarding CPR initiationNHTSAs National EMS Information System (NEMSIS) and/or AED application, defibrillation, initial arrestversion 3.5. Future efforts will focus on alignment of rhythm, return of spontaneous circulation [ROSC], fieldCARES supplemental data fields with NEMSIS v3.6. hypothermia, and pre-hospital survival status). EMS providers are also able to enter a number of optionalThe CARES dataset is geocoded on an annual basis and elements, which further detail arrest interventions (i.e.linked to a number of census-tract level variables usage of mechanical CPR device, ITD, 12 Lead,including: median household income, median age, race automated CPR feedback device, and advanced airway;and ethnicity, unemployment rate, poverty status, administration of drugs; and diagnosis of STEMI). Theurbanicity, and educational attainment. 13'