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Study links high-rise living to lower survival rates for cardiac arrest

The sweeping views that come with living on the upper floors of a high-rise building may come with an unexpected risk: lower likelihood of surviving a cardiac arrest.

A Canadian study found that survival rates for people who had a cardiac arrest in a private home on the third floor or higher had significantly lower survival rates than those who had a cardiac arrest below the third floor. The results suggest that the extra time necessary for paramedics to reach higher floors, greater distance from the emergency vehicle, and increased time required to move the patient to the response vehicle may contribute to the lower survival rates.

Researchers from St. Michael’s Hospital in Toronto used data from the Toronto Regional RescuNet Epistry database, a registry of cardiac arrests that took place out of hospitals and received care from 911 responders. The study included 7,842 adult patients who had a cardiac arrest in a private residence from 2007 through 2012. Survival rate for the 5,998 patients who were below the third floor was 4.2 per cent. For the 1,844 patients on the third floor or higher, the survival rate was significantly lower: 2.6 per cent.

Survival rates decreased as floors increased. Above the 16th floor, survival rate was 0.9 per cent, and there were no survivors among the 30 patients who were above the 25th floor.

According to background information provided in the study, response time is crucial to survival of cardiac arrest, with survival rates decreasing by as much as 10 per cent per minute between the cardiac arrest and initial treatment. More and more people are living in high-rise buildings, and those buildings can pose access problems for emergency responders.

The study authors note that these results show the importance of response time between arrival of emergency responders at the site, and patient contact. Most studies of 911 response times look at time elapsed between 911 call and arrival at the site – not time to patient contact. The researchers suggest that measures such as giving paramedics universal elevator keys like those available to firefighters, alerting building security personnel, and providing defibrillators in highrise buildings may be useful.

The study was led by paramedic Ian Drennan, a researcher with Rescu, a group that studies out-of-hospital emergency healthcare. It was published online in CMAJ on Jan. 18, 2015.



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  • A publication of:
  • Women's College Hospital