Data Sharing User Guide - myCares Sharing User Guide… · A copy of the IRB approval must be...

0

Cardiac Arrest Registry to Enhance Survival

CARES

CARESDataSharingUserGuide


CARES

1

INDEX

WhatisCARES?……………………………………………………..…………………………………………………..............1

WhoownsCARESdata?………………………………………………………………….………………………...............1

WhatisaCAREScase?………………………………………………………………….………………………..................1

HowisCARESdatacollected?…………………………………………………………………..……………................1

WhatkindofdatadoesCAREScollect?………………………………………………………….………................2

HowcanIaccessCARESdata?…………………………………………………………………………………...............2

Myprojecthasbeenapproved.Whatarethenextsteps?…………………………………………...........3

I’mreadytostartmydataanalysis.WhatshouldIconsider?………………..……………………..........3

Authorship…………………………………………………………….…………………………………..............................4

Abstracts……………………………………………………………….…………………………………………………..............4

Manuscripts………………………………………..………………….………………………………….............................4

AppendixA:CARESForms………………………………………..………………………………….………………………..5

AppendixB:CARESDataSharingApplication…………………………………….….……………….……………..7

AppendixC:DataSharingChecklist………………………………...….……………………….…………………...…11

AppendixD:DataElementDefinitions………………………………...….……………………………..…………..12

AppendixE:CARESDatabaseStructure…………………………….……………………….………………………..14


CARES

1

WhatisCARES?

In2004,theCentersforDiseaseControlandPrevention(CDC)establishedtheCardiacArrestRegistrytoEnhanceSurvival(CARES)incollaborationwiththeDepartmentofEmergencyMedicineattheEmoryUniversitySchoolofMedicine.CARESwasdevelopedtohelpcommunitiesdeterminestandardoutcomemeasuresforout-of-hospitalcardiacarrest(OHCA),bylinkingthethreesourcesofinformationthatdefinethecontinuumofemergencycardiaccare:911dispatchcenters,emergencymedicalservices(EMS)providers,andreceivinghospitals.ParticipatingEMSsystemscancomparetheirperformancetode-identifiedaggregatestatistics,allowingforlongitudinalbenchmarkingcapabilityatthelocal,regional,andnationallevel.

CARESbegandatacollectioninAtlantain2005.Theprogramhassinceexpandedtoinclude20state-basedregistries(Alaska,California,Delaware,Hawaii,Illinois,Maine,Maryland,Michigan,Minnesota,Montana,Nebraska,NewHampshire,NorthCarolina,NorthDakota,Oregon,Pennsylvania,SouthCarolina,Utah,Vermont,andWashington)withmorethan60communitysitesin22additionalstates,representingacatchmentareaofapproximately107millionpeopleor33%oftheUSpopulation.Morethan1,400EMSagenciesandover1,800hospitalsparticipatenationwide.

WhoownsCARESdata?

CARESisasecureandconfidentialdatamanagementsystemthatallowsEMSagenciesandhospitalstomonitortheirperformanceandcomparethemselvesagainststateandnationalbenchmarks.LocalEMSagenciesandhospitalshaveownershipoftheirowndata.CARESiscommittedtomaintainingtheconfidentialityofEMSagencyandhospitaldata;therefore,alldataissharedinade-identified,aggregateformat.Fieldsthatcouldidentifyapatient,EMSagency,orhospitalareremovedfromresearchdatasets,andpublicationsshallnotseparatelyidentifyparticipatingEMSagencies,hospitals,ortheircontributeddata.Datasharingapplicationsandagreementsareproposal-specificandlimitedtoeachindividualproject.

WhatisaCAREScase?

EMSagenciesareinstructedtoincludeallout-of-hospitalcardiacarrests(OHCAs)ofnon-traumaticetiologywherethepatient:1)receivesresuscitativeeffortsfromFirstRespondersorEMS,or2)isdefibrillatedpriortoEMSarrival.CARESincludesOHCApatientsofallages.

ThefollowingarenotconsideredCAREScases:1)Arrestoccurringduringaninter-facilitytransfer,2)Resuscitativeeffortsnotinitiatedorterminatedduetorigor,lividity,decomposition,injuriesincompatiblewithlife,DoNotResuscitatedirective,and/orobvioussignsofdeath.

HowisCARESdatacollected?

TheCARESsoftware(https://mycares.net),developedandmaintainedbyPhysio-Control,Inc.,linksthreesourcestodescribeeachOHCAevent:1)911callcenterdata,2)EMSdata,and3)hospitaldata.TheregistryevaluatesOHCAeventsofnon-traumaticetiologythatinvolvepersonswhoreceivedresuscitativeefforts,includingCPRand/ordefibrillation.EMSinitiatesaCARESrecordandcansubmitdataintwoways:usingadata-entryformontheCARESwebsite,orviauploadfromanagency’selectronicpatient-carerecord(ePCR)system.Whenthepatientsurvivestothehospitalwithongoingresuscitation,CARESrequestsoutcomedatafromtherecievingfacility.


CARES

2

WhatkindofdatadoesCAREScollect?

DatacollectionwithinCARESisbasedontheUtstein-styledefinitions–astandardizedtemplateofuniformreportingguidelinesforclinicalvariablesandpatientoutcomesthatwasdevelopedbyinternationalresuscitationexperts1.

From2005-2012,onlypatientswithapresumedcardiacetiologywereincludedinCARES.However,inalignmentwiththeUtsteinguidelinesandILCORrecommendation,theregistry’sinclusioncriteriaweremodifiedinJanuary2013toincludeallpatientswithnon-traumaticOHCA.Assuch,dataanalysisisrestrictedtothe2013-2016dataset,whichincludesmorethan193,000records.

MandatorydataelementscollectedfromEMSprovidersincludedemographics(i.e.name,age,dateofbirth,incidentaddress,sex,andrace/ethnicity),arrest-specificdata(i.e.locationtypeofarrest,witnessstatus,andpresumedetiology),andresuscitation-specificdata(i.e.informationregardingCPRinitiationand/orAEDapplication,defibrillation,initialarrestrhythm,returnofspontaneouscirculation[ROSC],fieldhypothermia,andpre-hospitalsurvivalstatus).

EMSprovidersarealsoabletoenteranumberofoptionalelements,whichfurtherdetailarrestinterventions(i.e.usageofmechanicalCPRdevice,ITD,12Lead,automatedCPRfeedbackdevice,andadvancedairway;administrationofdrugs;anddiagnosisofSTEMI).

TheCARESformalsoincludesanumberofoptionaltimeelements,includingestimatedtimeofarrest,defibrillatoryshock,andinitialCPR.Supplementaldataelementscollectedfromthe911callcentersincludethetimethateach911callwasreceived,thetimeofdispatchforbothfirstresponderandEMSproviders,andarrivaltimeatthescene.

Dataelementscollectedfromreceivinghospitalsincludeemergencydepartmentoutcome,provisionoftherapeutichypothermia,hospitaloutcome,dischargelocation,andneurologicaloutcomeatdischarge(usingtheCerebralPerformanceCategories[CPC]Scale).Receivingfacilitiesmayalsocompleteoptionalelementsoutlininghospitalprocedures,includingcoronaryangiography,CABG,andstentorICDplacement.

TheCARESdatasetisgeocodedonanannualbasis,usingCentrusDesktopGeocoder,andlinkedtoanumberofcensus-tractlevelvariablesincluding:medianhouseholdincome,medianage,race,unemploymentrate,andeducationalattainment.

TheCARESforms(requiredelementsonly,andrequiredandsupplementalelements)arelocatedinAppendixA.

HowcanIaccessCARESdata?

InquiriesaboutthenationaldatasetshouldbedirectedtoKimberlyVellano([email protected]),DirectorofDataManagementforCARES.Inquiresaboutstate-specificprojectsshouldbedirectedtotherespectiveCARESStateCoordinator(contactinformation:https://mycares.net/sitepages/contactus.jsp).

ResearcherswhowanttoanalyzestateornationalaggregatedatamustsubmitaresearchproposaltotheCARESDataSharingCommittee.Eachuniqueprojectrequiresaseparateproposalsubmission.TheCARESDataSharingApplicationislocatedinAppendixB.Oncecompleted,theapplicationwillbedistributedtocommitteemembersforreview.Feedbackwillbeprovidedwithinfourweeksofsubmission.

ThegoalsofthenationalandstateDataSharingCommitteesareasfollows:

o TopromoteaccurateandscientificallysoundpresentationsandpapersfromtheCARESprogram.

1Resuscitation. 2015 Nov;96:328-40.


CARES

3

o TooverseetheuseofthedatabelongingtoEMSagenciesandhospitalsandprotectagencyandhospitalconfidentiality.

o Toensurethatallinvolvedpartieshaveconsentedtotheuseoftheirdata,or,iftheresearchoranalysisisde-identified,cumulativedata,thatitisapprovedbyacommittee.

o Toensureparticipationandsupportfromallstakeholders.

o Toavoidduplicationofeffortanddatamining.

Thecommitteeevaluatestheproposalforscientificmeritandmakesrecommendations.Iftherearenoconcernsorissuesraised,theresearcherwillbeinformedthattheirproposalhasbeenapproved.Anycommentsorsuggestionsfromthecommitteewillbesharedwiththeleadinvestigator.

Myprojecthasbeenapproved.Whatarethenextsteps?

AnoverviewoftherequiredstepscanbefoundintheDataSharingChecklist(AppendixC).

Step1:Non-DisclosureAgreement&IRBapproval

PriortoreceiptoftheCARESdataset,theleadresearchermustsignaNon-DisclosureAgreementforInformationRecipientsstatingtheywillnotsharethedatasetorexpandtheanalysisbeyondthescopeoftheproposal.ThesignedNDAshouldbesenttotheCARESDataSharingCoordinatorforfinalexecutionbyEmoryUniversity.Afullyexecutedcopywillbereturnedonceavailable.

LeadauthorsmustobtainIRBapprovalfromtheirinstitutionswithin3monthsofreceivingthedatasetforanalysis.AcopyoftheIRBapprovalmustbesharedwiththeCARESDataSharingCoordinator.

Step2:Datasetreviewwebinar

AfterapprovaloftheproposalbytheDataSharingCommittee,theCARESDataSharingCoordinatorwillprovidetherequestedde-identifieddatasetspecifictothestudyproposal.TheDataSharingCoordinatorwillscheduleawebinarwiththestudyinvestigatorsandaffiliatedstatisticalstafftoreviewthedatasetandanswerquestionsaboutinterpretationoftheCARESelements.

I’mreadytostartmydataanalysis.WhatshouldIconsider?

Dataelementdefinitionsandcodingconsiderations(includinginformationaboutlocationtype,bystanderCPR,PAD,andpatientoutcome)arefoundinAppendixD.AdditionalinformationcanbefoundintheCARESDataDictionary(https://mycares.net/sitepages/dataelements.jsp).

DetailsregardingthedatasetstructureandrelationshipsbetweenCARESquestionsarefoundinAppendixE.

Step3:Senddescriptivedatatablesforreviewpriortofurtheranalysis

DescriptivedatatablesshouldbesharedwiththeCARESDataSharingCoordinatorforreviewpriortofurtheranalysis.Thiswillallowforfeedbackregardinginclusion/exclusioncriteria,dataelementinterpretation,andcodinginadvanceofmoresophisticatedanalyses.


CARES

4

Authorship

AuthorswhoparticipateinthewritingofamanuscriptshoulddosoinaccordancewiththeInternationalCommitteeofMedicalJournalEditorsguidelines(JAMA1997;277(11):927-934).

Allabstracts/manuscriptswrittenusingCARESdatawillusethefollowingformattolistauthorship:

o Individualauthorswillbelistedfirst.

o Allabstracts/manuscriptsshouldincludethewords“andtheCARESSurveillanceGroup”intheauthorshiplinefollowingtheindividualauthors(e.g.SchwammL,GeorgeM,MattersM,andtheCARESSurveillanceGroup).

The"Acknowledgement"sectionofallmanuscriptsshouldreferencetheCARESparticipatingsitesbyprovidingtheweblinkhttps://mycares.net/sitepages/map.jsp.

Abstracts

Abstractorpresentationproposalsmustbefollowedupwithasubmissionwithinthreemonthsofthedatethatthedatasetisprovided.

AbstractsforpresentationsatscientificmeetingsshouldbesenttotheDataSharingCommitteeforapprovalpriortosubmission.Committeememberswillreviewtheabstracttodeterminewhetheritisaccurateandscientificallysound.Thecommitteewillrespondtotheinvestigatorswithintwoweeksofsubmissionforabstracts.Underverylimitedcircumstances,aresearchermaycallforanexpeditedreviewofanabstract.Requestsforanexpeditedreviewshouldbesubmittedtothecommitteewithjustificationfortheneedtoexpeditethereview.Failureoftheresearchertocompletetheworkinatimelymannerand/orfailuretodeterminedeadlinespriortobeginningtheprojectDOESNOTjustifyexpeditedreview.

AcopyofacceptedabstractsshouldbesenttotheCARESDataSharingCoordinatorfortherecord.

Manuscripts

Manuscriptsmustbesubmittedforreviewwithinninemonthsofthedatethatthedatasetisprovided.

DraftmanuscriptsshouldbesenttotheDataSharingCommitteeforapprovalpriortojournalsubmission.Committeememberswillreviewthemanuscripttodeterminewhetheritisaccurateandscientificallysound.Thecommitteewillrespondtotheinvestigatorswithinfourweeksofsubmissionformanuscripts.Underverylimitedcircumstances,aresearchermaycallforanexpeditedreview.Requestsforanexpeditedreviewshouldbesubmittedtothecommitteewithjustificationfortheneedtoexpeditethereview.Failureoftheresearchertocompletetheworkinatimelymannerand/orfailuretodeterminedeadlinespriortobeginningtheprojectDOESNOTjustifyexpeditedreview.

TheCARESDataSharingCoordinatorshouldbenotifiedwitheachjournalsubmissionandpeerreview,inordertotrackprojects.

AcopyofacceptedpublicationsshouldbesenttotheCARESDataSharingCoordinatorfortherecord.


CARES

5

AppendixA:CARESForms

CARESRequiredElements:


CARES

6

CARESRequired&SupplementalElements:


CARES

7

AppendixB:CARESDataSharingProposalForm

ThankyouforyourinterestintheCardiacArrestRegistrytoEnhanceSurvival(CARES).ToinitiatearesearchprojectutilizingCARESdata,pleasecompletetheapplicationbelowandsubmitelectronicallytoKimberlyVellanoatkhauste@emory.edu.TheproposalwillbereviewedbytheCARESDataSharingCommitteewithin4weekstodeterminethatitisscientificallysoundandthatthescopeoftheanalysisisreasonable.Ifthecommitteeapprovestheproposal:

• CARESstaffwillconductawebinartoreviewthedataelementsandanswerquestionspriortoprovidingtheresearcherwiththede-identifieddataset.

• TheresearchermustsignaNon-DisclosureAgreementstatingtheywillnotsharethedatasetorexpandtheanalysisbeyondthescopeoftheproposal.

• Abstractsforpresentationsatscientificmeetingsshouldbesubmittedwithin3monthsofreceiptofthedataset.AbstractsmustbesenttotheCARESDataSharingCommitteeforreview2weeksinadvanceofsubmission.

• Publicationmanuscriptsshouldbesubmittedwithin9monthsofreceiptofthedataset.ManuscriptdraftsmustbesenttotheCARESDataSharingCommitteeforreview4weeksinadvanceofsubmission.

MoredetailedinformationabouttheCARESDataSharingPolicyandGuidelinescanbefoundat:https://mycares.net/sitepages/datashare.jsp.

PrimaryContactInformationName:

Title:

Hospital/University/Company:

StreetAddress:

City,State,Zip:

Phone:

Email:


CARES

8

Projectname/Workingtitle:Leadinvestigator:TargetConference:TargetJournal:

A) StudyInvestigators

Name Institution Email(required)

1.

2.

3.

4.

5.

6.

7.

8.

B) Mainobjective,aim,orhypothesis

C) Background/Rationale


CARES

9

D) MethodsSpecificoutcome(s)ofinterest:Explanatoryvariablesofinterest:

Studypopulation(inclusion/exclusioncriteria):Analysisplan(withpowercalculationsandplansforobtainingstatistical/epidemiologicalexpertise,ifrelevant):


CARES

10

E) Relevantreferences

FORUSEBYCARES:Datesubmitted:CARESDSCdeadline:Dateapproved:

DSCFeedback/Comments:


CARES

11

AppendixC:DataSharingChecklist

¨ SignCARESNon-DisclosureAgreementforInformationRecipients

¨ CompletedatasetreviewwebinarwithCARESDataSharingCoordinator

¨ SubmitIRBapprovallettertoCARESDataSharingCoordinatorwithin3monthsofreceiptofdataset

¨ SenddescriptivedatatablestoCARESDataSharingCoordinatorforreviewpriortofurtheranalysis

o Submitabstractsforpresentationsatscientificmeetingswithin3monthsofreceiptofdataset

o SendabstracttoCARESforcommitteereview2weeksinadvanceofsubmission

o Include"andtheCARESSurveillanceGroup"intheauthorshiplinefollowingtheindividualauthors

o IncludeCARESlogoonposter

o Submitpublicationmanuscriptswithin9monthsofreceiptofdataset

o SendmanuscripttoCARESforcommitteereview4weeksinadvanceofsubmission

o Include"andtheCARESSurveillanceGroup"intheauthorshiplinefollowingtheindividualauthors

o InAcknowledgementssection,referencetheCARESparticipatingsitesbyprovidingtheweblink:https://mycares.net/sitepages/map.jsp.

o SendtoCARESforre-reviewifthemanuscriptisrevisedbasedonpeerreviewprocess

¨ SendacopyofacceptedabstractormanuscripttoCARESDataSharingCoordinator


CARES

12

AppendixD:DataElementDefinitionsCARESCaseDefinition:ACAREScaseisanon-traumaticout-of-hospitalcardiacarresteventwhereresuscitationisattemptedbya911responder(CPRand/ordefibrillation).ThisincludespatientsthatreceivedanAEDshockbyabystanderpriortothearrivalof911responders.CAREScollectedonlyarrestsofpresumedcardiacetiologyfrom2005-2012.In2013,CARESexpandedtoincludeallnon-traumaticarrests.LocationType:Typeoflocationwherethepatientarrested.CARESlocationtypesaregenerallygroupedintothefollowing:

• Home/Residence:Home/Residence• NursingHomeorHealthcareFacility:NursingHome;HealthcareFacility• Public:Public/CommercialBuilding;Street/Highway;PlaceofRecreation;IndustrialPlace;

TransportCenter;OtherBystander-Alayperson,laypersonfamilymember,orlaypersonmedicalprovider.FirstResponder–Personnelwhorespondtothemedicalemergencyinanofficialcapacityaspartofanorganizedmedicalresponseteambutarenotthedesignatedtransporterofthepatienttothehospital.EmergencyMedicalServices(EMS)-Personnelwhorespondtothemedicalemergencyinanofficialcapacity(i.e.respondtothe911call)aspartofanorganizedmedicalresponseteamandarethedesignatedtransporterofthepatienttothehospital.BystanderCPR–Cardiopulmonaryresuscitationinitiatedbyalayperson,laypersonfamilymember,or

laypersonmedicalprovider.

BystanderCPRRate:Werecommendexcluding911Responderwitnessedeventsaswellasthosethatoccurredinanursinghome/healthcaresettingfrombystanderCPRratecalculations,asthesearescenarioswhereatrainedmedicalprofessionalwouldmostlikelybeperformingCPR.

Exclude“ArrestWitnessStatus=911ResponderWitnessed”AND“LocationType=NursingHome;HealthcareFacility”fromnumeratoranddenominator.

Numerator:WhoInitiatedCPR=layperson,laypersonfamilymember,orlaypersonmedicalprovider

AEDApplication:“WasanAEDappliedpriortoEMSarrival”denotesAEDapplicationbyalaypersonorFirstResponderpriortothearrivalofEMS,regardlessofwhetherdefibrillationoccurred.“Yes,withdefibrillation”,and“Yes,withoutdefibrillation”arebothaffirmativeresponsestothisquestion.

PADRate:WhentheoutcomeofinterestistheuseofanAEDbyabystander,werecommendexcluding911Responderwitnessedeventsaswellasthosethatoccurredinahealthcarefacilityornursing


CARES

13

home,asthesearescenarioswhereatrainedmedicalprofessionalwouldmostlikelybeapplyinganAEDormonitor.AEDsarerarelyusedduringcardiacarrestsoccurringinresidentiallocations;therefore,werecommendexcludingarreststhatoccurredinanon-publiclocationandevaluatingthepublicaccessdefibrillation(PAD)rate.

Exclude“ArrestWitnessStatus=911ResponderWitnessed”AND“LocationType=NursingHome;HealthcareFacility;Home/Residence”fromnumeratoranddenominator.

Numerator:WhofirstappliedtheAED=layperson,laypersonfamilymember,orlaypersonmedicalprovider

Whofirstdefibrillatedthepatient?–Usedtodeterminethefrequencyofdefibrillatoryshocksamongbystandersandresponders.“NotApplicable”isselectedwhendefibrillationdidnotoccur.FirstArrestRhythm-Firstcardiacrhythmpresentwhenamonitor/defibrillatororAEDisattachedtoapatient.SustainedROSC-ReturnofSpontaneousCirculation(ROSC)isdefinedastherestorationofapalpablepulseorameasurablebloodpressure.SustainedROSCisdeemedtohaveoccurredwhenchestcompressionsarenotrequiredfor20consecutiveminutesandsignsofcirculationpersist.“Yes”,“Yes,butpulselessatendofEMScare”,and“Yes,pulseatendofEMScare”areallaffirmativeresponsestothisquestion.Fieldhypothermia-Measuresweretakeninthefieldtoreducethepatient’sbodytemperaturebymeansofexternalcoldpackapplicationtoarmpits/groinoradministrationofcoldintravenoussalinebolus,withorwithoutsedationorothermedications.Survivedtohospitaladmission-IncludespatientsforwhomEROutcome=Admittedtohospital.Survivedtohospitaldischarge-IncludespatientsforwhomHospitalOutcome=DischargedAliveorPatientMadeDNR=DischargedAlive.GoodCerebralPerformance–CPC1;Patientisconscious,alert,abletoworkandleadanormallife.ModerateCerebralPerformance–CPC2;Patientsisconsciousandabletofunctionindependently(dress,travel,preparefood),butmayhavehemiplegia,seizures,orpermanentmemoryormentalchanges.UtsteinPatients-Thosewhohadabystanderwitnessedarrestandpresentedinashockablerhythm.ToviewCARESUtsteinpatients,selectthefollowing:

• ArrestWitnessStatus=BystanderWitnessed• FirstRhythmType=Shockable

UtsteinBystanderSurvival-Survivalamongpatientswhosecardiacarrestwaswitnessedbyabystander,wereinashockablerhythm,andreceivedsomebystanderintervention(CPRand/orAEDapplication).


CARES

14

AppendixE:CARESDatabaseStructure

ThetablebelowincludesdetailsabouttheCARESdatasetstructure,includingthedataelementsandresponses,andrelationshipsbetweenCARESquestions.Lightgreyshadingindicatesthe

supplemental/optionalCARESdataelements.

Header TitleonCARESForm Responses Description/CommentsRunID N/A UniquerecordidentifiergeneratedbyCARESsoftware.

EMSAgencyID N/A UniqueEMSagencyidentifiergeneratedbyCARES.IncludedinCARESdatasetwhenneededforanalysis.DateofArrest DateofArrest Age(Years) Age/AgeModifier Patientage,inyears.Daysandmonthshavebeenconvertedaccordingly.

Gender Gender Male

Female

Race/Ethnicity Race/Ethnicity

American-Indian/Alaskan

Asian

Black/AfricanAmerican

Hispanic/Latino

NativeHawaiian/PacificIslander

White

Unknown

Raceis"Unknown"forapproximately25%ofCAREScases,duetothefactthatanumberofcommunities

donotcollectthisinformation.

MedicalHistory MedicalHistory

No

Unknown

Cancer

Diabetes

HeartDisease

Hyperlipidemia

Hypertension

RenalDisease

RespiratoryDisease

Stroke

Other

DestinationHospitalID N/A UniquehospitalidentifiergeneratedbyCARES.IncludedinCARESdatasetwhenneededforanalysis.

LocationType LocationType

Home/Residence

Public/CommercialBuilding

Street/Hwy

NursingHome

HealthcareFacility

PlaceofRecreation

IndustrialPlace

TransportCenter

Other

ArrestWitnessStatusArrestWitnessed/ArrestAfter

Arrivalof911Responder

Unwitnessed

BystanderWitnessed

911ResponderWitnessed

Thisvariablemapsresponsesfrom"ArrestWitnessed"and"ArrestAfterArrivalof911Responder".

PresumedCardiacArrest

EtiologyPresumedCardiacArrestEtiology

PresumedCardiacEtiology

Trauma

Respiratory

Drowning

Electrocution

DrugOverdose

Exsanguination/Hemorrhage

Other

From2005-2012,CARESonlyrequiredarrestsofpresumedcardiacetiologytobeentered.InJanuary

2013,ourcasedefinitionexpandedtoincludeallnon-traumaticworkedarrests.AnalysesusingCARES

dataMUSTincludeallnon-traumaticetiologies.

DrugOverdoseandExsanguination/HemorrhagearenewanswerchoicesasofJanuary2017.Priorto

this,theseetiologieswerecodedasOther.


CARES

15

Header TitleonCARESForm Responses Description/Comments

ResuscitationAttempted

ResuscitationAttemptedby911

Responder(orAEDshockgivenprior

toEMSarrival)

Yes

No

CARESrequiresthatcardiacarresteventswhereresuscitationwasattemptedbeenteredintothe

registry.DOAs/unworkedarrestsarenotCAREScasesandarethereforeremovedfromdatasets.

InitiatedCPR WhoInitiatedCPR

NotApplicable

LayPerson

LayPersonFamilyMember

LayPersonMedicalProvider

FirstResponder(non-EMS)

RespondingEMSPersonnel

TypeofBystanderCPR

ProvidedTypeofBystanderCPRProvided

Compressionsandventilations

Compressionsonly

Ventilationsonly

ThisfieldisapplicableonlyifInitiatedCPR=LayPerson,LayPersonFamilyMember,orLayPerson

MedicalProvider.

DispatcherCPRinstructions

provided

WereDispatcherCPRinstructions

provided?

Yes

No

Unknown

WasanAEDappliedpriorto

EMSarrival

WasanAEDappliedpriortoEMS

arrival

Yes,withdefibrillation

Yes,withoutdefibrillation

No

WhoFirstAppliedtheAED WhoFirstAppliedtheAED

LayPerson



FirstResponder

Thisfieldisapplicableonlyif"WasanAEDappliedpriortoEMSarrival"="Yeswithdefibrillation"or"Yes

withoutdefibrillation".

DidpolicefirstapplytheAED Ifyes,wasitappliedbypolice?Yes

NoThisfieldisapplicableonlyif"WhoFirstAppliedtheAED"=FirstResponder.

WhoFirstDefibrillatedthe

PatientWhoFirstDefibrillatedthePatient

NotApplicable

LayPerson



FirstResponder(nonEMS)

RespondingEMSPersonnel

ThisquestionincludesNotApplicableasaresponse,forcaseswherenoshockwasgiven.Thisquestionis

notspecifictoAEDs,butappliestodefibrillationwithanydevice.

Didpolicefirstdefibrillatethe

patient

Ifyes,didpolicedefibrillatethe

patient?

Yes

NoThisfieldisapplicableonlyif"WhoFirstDefibrillatedthePatient"=FirstResponder.

Did911Responderperform

CPRDid911ResponderperformCPR

Yes

No

FirstMonitoredRhythm FirstArrestRhythmofPatient

VentricularFibrillation

VentricularTachycardia

Asystole

Idioventricular/PEA

UnknownShockableRhythm

UnknownUnshockableRhythm

Firstcardiacrhythmpresentwhenamonitor/defibrillatororAEDisattachedtoapatient.

UnknownShockableorUnknownUnshockableareincludedforsituationswherethedevicelacked

recordingability.

FirstRhythmType N/AShockable

Non-Shockable

CategorizesFirstMonitoredRhythmasShockable(VF,VT,UnknownShockable)orNonshockable

(Asystole,Idioventricular/PEA,UnknownUnshockable).

SustainedROSC

SustainedROSC(20consecutive

minutes)orpresentatendofEMS

care

Yes

Yes,butpulselessatendofEMScare

Yes,pulseatendofEMScare

No


CARES

16


WhendidsustainedROSC

firstoccurWhendidsustainedROSCfirstoccur

Never

AfterBystanderCPROnly

AfterBystanderdefibshock

After911ResponderCPRonly

After911Responderdefibshock

AfterALS

Unknown

Washypothermiacare

providedinthefield

Washypothermiacareprovidedin

thefield

Yes

No

MechanicalCPRdeviceUsed MechanicalCPRdeviceUsedYes

No

MechanicalCPRdeviceUsed

detailIf"Yes",pleasespecify:

Load-DistributingBand(AutoPulse)

ActiveCompressionDecompression

(LUCASDevice)

MechanicalPiston

Other

ApplicablewhenMechanicalCPRdeviceUsed=Yes.

AutomatedCPRfeedback

deviceused

AutomatedCPRfeedbackdevice

used

Yes

No

AdvancedAirwaysuccessfully

placedinthefield

AdvancedAirwaysuccessfully

placedinthefield

Yes

No

AdvancedAirwaydetail If"Yes",pleasespecify:

Combitube

KingAirway

LMA

Oral/NasalET

Other

ApplicablewhenAdvancedAirwaysuccessfullyplacedinthefield=Yes.

ITDUsed ITDUsedYes

No

ITDUseddetail If"Yes",pleasespecify:

Bagvalvemask

Endotrachealtube

Combitube

KingAirway

LMA

Oral/NasalET

Other

ApplicablewhenITDUsed=Yes.

Weredrugsadministered WeredrugsadministeredYes

No

Drugsadministereddetail If"Yes",pleasespecify:

Epinephrine

Atropine

Amiodarone

Bicarbonate

Dextrose

Lidocaine

Vasopressin

Other

ApplicablewhenWeredrugsadministered=Yes.

Vascularaccess Vascularaccess

NoIV

IV

IO

12Lead 12LeadYes

No


CARES

17


STEMI STEMI

Yes

No

Unknown

STEMILocation If"Yes",selectlocation:Anterior

InferiorApplicablewhenSTEMI=Yes.

EndOfTheEvent EndOfTheEvent

DeadinField

PronouncedDeadinED

EffortCeasedduetoDNR

OngoingResuscitationinED

CARESdoesnotrequirethatfieldDNRsbeenteredintotheregistry.DNRsarenotCAREScasesandare

thereforeremovedfromdatasets.

EmergencyRoomOutcome EmergencyRoomOutcome

ResuscitationterminatedinED

Admittedtohospital

Transferredtoanotheracutecarefacility

fromtheED

ThisistheseconddataelementwhichcanindicatethatthepatientdiedintheED(see"Endofthe

Event").Ifpatientwasadmittedtothehospital,thefollowinghospitalquestions(HypothermiaCare&

HospitalOutcome)areapplicable.

SurvivedtoHospital

AdmissionN/A

Yes

No

Missing

Thisdataelementindicateswhetherthepatientsurvivedtohospitaladmission,andmapsresponses

from"EndoftheEvent"and"EROutcome".

HospitalOutcome HospitalOutcome

Diedinthehospital

DischargedAlive

PatientmadeDNR

Transferredtoanotheracutecare

hospital

Notyetdetermined

Ifthepatientdiedinthehospital,therecordiscomplete.Iftheyare"DischargedAlive"thenthe

followinghospitalquestions(DischargefromtheHospitalandNeuroOutcome)areapplicable.

PatientmadeDNRoutcome PatientmadeDNRoutcome

Diedinthehospital

DischargedAlive

Transferredtoanotheracutecare

hospital

Notyetdetermined

If"HospitalOutcome=PatientmadeDNR",thenthehospitaluserispromptedtoenterthefinalpatient

outcomefromadrop-downmenu.

SurvivedtoHospital

DischargeN/A

Yes

No

Missing

Thisdataelementindicateswhetherthepatientsurvivedtohospitaldischarge,andmapsresponsesfrom

"SurvivedtoHospitalAdmission","HospitalOutcome",and"PatientmadeDNROutcome".

DischargeFromTheHospital DischargeFromTheHospital

Home/Residence

RehabilitationFacility

SkilledNursingFacility/Hospice

NeurologicalOutcomeNeurologicalOutcomeatDischarge

fromHospital

GoodCerebralPerformance(CPC1)

ModerateCerebralDisability(CPC2)

SevereCerebralDisability(CPC3)

Coma,vegetativestate(CPC4)

CPCScore N/A

CPC1/2

CPC3/4

Missing

ThisdataelementmapsneurologicaloutcometoCPCScore,groupingCPC1and2,andCPC3and4.We

recommendthatCPC1and2begroupedtogetherasapositiveneurologicaloutcome.

Hospital-Washypothermia

careinitiated/continued

Washypothermiacareinitiatedor

continuedinthehospital

Yes

NoThisfieldisapplicableonlyifEROutcome=Admittedtohospital.

OriginalEmergencyRoom

OutcomeN/A

TransferHospitalID N/A UniquetransferhospitalidentifiergeneratedbyCARES.IncludedinCARESdatasetwhenneededfor

analysis.

Hospital(Trans)-Was

hypothermiacare

initiated/continued

N/A Thisfieldisapplicableonlyifthepatientwastransferredandadmittedtoasecondaryreceivingfacility.


CARES

18


Whywashypothermiacare

notinitiatedorcontinuedin

thehospital?

Whywashypothermiacarenot

initiatedorcontinuedinthe

hospital?

Awake/Followingcommands

DNR/Familyrequest

Unwitnessedcardiacarrest

Unshockablerhythm

NoTHprograminplace

Other

Thissupplementalhospitalelementwasaddedin2016.

FinalDiagnosisMyocardial

Infarction

Wasthefinaldiagnosisacute

myocardialinfarction

Yes

No

CoronaryAngiography

PerformedCoronaryAngiographyPerformed

Yes

No

Unknown

CoronaryAngiographyDateIf"Yes",pleaseprovidedateand

time:MM/DD/YY ThisfieldisapplicableonlyifCoronaryAngiographyPerformed=Yes.

CoronaryAngiographyTimeIf"Yes",pleaseprovidedateand

time:HH:MM ThisfieldisapplicableonlyifCoronaryAngiographyPerformed=Yes.

Wasacardiacstentplaced Wasacardiacstentplaced

Yes

No

Unknown

CABGPerformed CABGPerformed

Yes

No

Unknown

ICDplacedand/orscheduled WasanICDplacedand/orscheduled

Yes

No

Unknown

EstimatedTimeOfArrest EstimatedTimeOfArrest HH:MM:SS

Timeof1stCPR Timeof1stCPR HH:MM:SS

Timeof1stDefibrillation Timeof1stDefibrillatoryShock HH:MM:SS

CallReceivedAtDispatch

CenterTimecallreceivedatdispatchcenter HH:MM:SS

FRDispatched TimeFirstResponderdispatched HH:MM:SS

FREnRoute TimeofFirstResponderenroute HH:MM:SS

AmbulanceDispatched TimeAmbulancedispatched HH:MM:SS

AmbulanceEnRoute TimeforAmbulanceenroute HH:MM:SS

FROnSceneTimeFirstResponderarrivedat

sceneHH:MM:SS

AmbulanceOnScene TimeAmbulancearrivedatscene HH:MM:SS

EMSAtPatientSide TimeEMSarrivedapatient'sside HH:MM:SS

AmbulanceLeftScene TimeAmbulanceleftscene HH:MM:SS

AmbulanceArrivedAtED TimeAmbulancearrivedatED HH:MM:SS

Date post:	17-May-2020
Category:	Documents
Upload:	others
View:	6 times
Download:	0 times

Data Sharing User Guide - myCares Sharing User Guide… · A copy of the IRB approval must be...

Documents