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PERFORMANCE BENCHMARKS different than being discharged alive from a hospital, and the outcome of a patient who is obviously dead on EMS arrival should be measured differently than one whose collapse was witnessed. A universal cardiac arrest reporting template was developed in 1991 among an international group of resuscitation experts at a conference in Norway. Known as the Utstein template, this provides common defnitions of different arrest types and survival. The template includes whether the arrest was witnessed, its suspected cause and the rhythm presenting to EMS. It also tracks the outcomes of patients and assigns a cerebral performance category to measure the neurologic function of survivors.8 Unfortunately, many communities do not track the outcomes of cardiac arrest patients, and even fewer use the Utstein template. In a more recent survey of EMS systems serving the 200 most populous cities, 52% of respondents used a local template that doesn't allow comparison to other services.9 A number of system factors affect the likelihood of survival from cardiac arrest. One is how long it takes for CPR and a defbrillator to arrive after collapse. The 2008 Eagles benchmark paper recommends a fve-minute response for CPR and defbrillator-equipped frst responders. 1 Another factor is the quality of care rendered after help arrives, and both can be objectively measured. Monitors now capture and archive times, compression rate, depth, recoil and duration of pauses. CPR quality can also be indirectly measured with archived heart rate and end-tidal CO2 readings. Since better outcomes have been shown in patients treated by experienced paramedics, it is also useful to know how many arrests each paramedic has the opportunity to manage. Some services have adjusted response patterns to add experienced paramedics to cardiac arrests. While it is not reasonable to expect every patient in cardiac arrest to be saved, don't members of each community deserve to know how well their EMS service performs compared to others? Don't people in Detroit deserve the same chance of surviving as those in Raleigh? It is time for us to be transparent about how well we do, stop making excuses and spread the best practices of communities with high survival rates. Cardiac arrests constitute about 1% of EMS calls, but improving cardiac arrest management will also improve care for patients with other complaints. Better tracking of cardiac arrest data opens the door to tracking other objective clinical performance measures. STEMI According to the 2008 Eagles bench- Pen n Stat e | On l i n e Ready to achieve your career goals? Our Master of Professional Studies in Homeland Security—Public Health Preparedness Option can give you the confidence to lead during any emergency. Apply today to the nation's first online homeland security program offered by a medical school, Penn State Milton S. Hershey Medical Center. Don't wait another minute. www.worldcampus.psu.edu/EMS12 U.Ed.OUT 12-0700/12-WC-0444ajc/jms/smb For More Information Circle 31 on Reader Service Card EMSWORLD.com | JUNE 2013 37