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Each year, cardiac arrest strikes more than half a million people and contributes to avoidable death and disability across the United States; it affects seemingly healthy individuals of all ages, races, and genders, often without warning. Defined as a severe malfunction or cessation of the electrical and mechanical activity of the heart, cardiac arrest results in almost instantaneous loss of consciousness and collapse. Following a cardiac arrest, each minute without treatment decreases the likelihood of survival with good neurologic and functional outcomes. Thus, the consequences of delayed action can have profound, and in many cases, avoidable ramifications for individuals, families, and communities. The Institute of Medicine conducted a study on the current status of, and future opportunities to improve, cardiac arrest treatment and outcomes in the United States. This report examines the complete system of response to cardiac arrest in the United States and identifies opportunities within existing and new treatments, strategies, and research that promise to improve survival and recovery of patients.