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High-rise living may affect survival after cardiac arrest

Penthouse living may have some drawbacks.

A new study in the Canadian Medical Association Journal suggests that residents of high-rise buildings had better survival rates from cardiac arrest if they lived on floors one through three. Survival was sketchy, though, for people who lived higher and very poor for those on the 16th floor and up.

"The higher up you are, the worse off you are after a cardiac arrest," study author Ian Drennan told CBS News. Drennan is a paramedic with York Region Paramedic Services and a researcher with Rescu, a group based at St. Michael's Hospital that studies emergency health care that begins outside of a hospital.

He and colleagues analyzed data on about 8,000 cardiac arrest patients who lived in houses, townhomes, apartments and condos and who were treated by 911 emergency responders.

The researchers were specifically interested in outcomes for people who lived in high-rise buildings. Drennan said buildings can pose challenges for paramedics due to access issues, maneuvering equipment through entrances and elevator delays. They looked at the interval time between the arrival of an emergency vehicle to the time 911-initiated first responders reached a patient in cardiac arrest.

Out of 5,998 cardiac arrest patients who lived below the third floor in high-rise buildings, 252 (4.2 percent) survived. Fewer patients, 48 (2.6 percent) out of 1844 people, who lived above the third floor survived.

When the scientists crunched the numbers floor by floor, they found a survival rate of only 0.9 percent for those living above the 16th floor (2 of 216 cardiac arrest sufferers) and no survivors (0 out of 30) in residents who lived above the 25th floor.

The researchers noted that the use of automated external defibrillators (AEDs) was very low.

"The 911 response time, from emergency activation to arrival of first responders on scene, will remain relatively constant, so long as traffic patterns do not change; however, the time from arrival on scene to initial patient contact may increase as more of the population comes to live at or above the third floor," the authors wrote.

Drenna said they can't say living on higher floors causes more death because this was only an observational study, but he said the findings suggest people living higher up have a worse chance of survival after cardiac arrest.

"It raises an awareness that it might take first-responders a little longer to get up there for a variety of reasons. You just happen to be farther from the truck. Minutes count, especially something like cardiac arrest. The faster someone can have an AED applied to them or get CPR, the better," Drennan said.

He said it also highlights the need for more people in the community to learn CPR and to know how to use an AED.

Dr. Rober‎t Glatter, an emergency physician at Lenox Hill Hospital, said, "The importance of early CPR, namely high quality and effective chest compressions, is the most important thing we can stress to bystanders who encounter a person in cardiac arrest."

People who choose to live above the third floor in a high rise especially need to be proficient in CPR and the use of an AED to ensure the safety of themselves and their loved ones, Glatter said.

"The bottom line is that it's important residents of high rise buildings understand the inherent risks of living on high floors due to prolonged response times for all medical emergencies, including cardiac arrest," Glatter added.

Heart disease patients may want to weigh the risks of high-rise living and consider lower floor residences, he said.

More AEDs may need to be placed in buildings, Drennan added. "And more research needs to be done on where the optimal spots for AEDs are - lobby-located AEDs or elevator AEDs," he said.

"Having some response plan in these buildings, so they know 911 responders are coming, and making sure firefighters and paramedics can get through the front door," may also improve survival, Drennan said.

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