The Unexpected Dangers of High-rise Living

By: Amarita Atwal

There can be a downside to living on the upper floors of high-rise apartments and condominiums for residents who suffer a cardiac arrest and require rapid emergency treatment [1]. It appears as though residents on higher floors whom experience cardiac arrests have reduced survival rates compared with those on lower floors [1]. This is likely a result of longer response times of first responders to reach these individuals and begin resuscitation efforts. It has previously been shown that longer response times, as determined by arrival on scene, reduces the odds the individual has for survival [2]. This previous research neglected to take into account vertical delay, or the time between arrival on scene and patient contact, which was the primary focus of a recent study based in Toronto. Researchers at Toronto’s St. Michael’s Hospital retrospectively examined close to 8,000 cases of cardiac arrest between 2006 and 2011 that occurred in private residences, including high-rises, houses and townhomes [1]. Those who lived on the ground or second floor had higher survival rates in the study. The data showed 4.2% of these individuals survived to hospital discharge whereas survival dipped to 2.6% for patients on or above the third floor. Above the 16th floor, the survival rate was “negligible” — less than 1%. The statistics are most grim, though, for individuals who went into cardiac arrest on or above the 25th floor, with zero survival [1]. Interventions aimed at shortening response times, specifically the vertical delay time, to treatment of cardiac arrest in high-rise buildings may increase survival, especially if more AEDs are placed on higher floors [1]. Overall, it seems that those most at risk of cardiac arrest may want to seriously consider living on lower levels of most building types.

[1]. Drennan, I.R., Strum, R. P., Byers, A., et al. Out-of-hospital cardiac arrest in high-rise buildings: delays to patient care and effect on survival. CMAJ 2016;1-7.

[2]. O’Keeffe C, Nicholl J, Turner J, et al. Role of ambulance response times in the survival of patients with out-of-hospital cardiac arrest. Emerg Med J 2011;28:703-6.

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