The study examined 7842 out-of-hospital-cardiac-arrests and determined that 4.2% of victims survived if they lived below the third floor with this figure dropping to 2.6% for those living on the third floor or higher. Above the 25^th floor, nobody survived.

This is a particularly pertinent issue when Australia is undergoing a residential high-rise boom in construction particularly in the eastern seaboard capitals of Sydney, Melbourne and Brisbane. But the impact of this study not only affects residents of high rise apartments but also office workers and hotel patrons.

Image courtesy of Business Insider

Responding to cardiac arrest victims in high rise buildings is difficult for the following reasons according to the authors: “Building access issues, elevator delays and extended distance from the location of the responding vehicle on scene to the patient can all contribute to longer times to patient contact and, ultimately, longer times to initiation of resuscitation.”

After a patient collapses from cardiac arrest deterioration occurs rapidly and death ensues unless a defibrillator is on hand. Even when the resuscitation team accesses the patient, transporting them down many floors to the ambulance takes the focus and attention away from continuous and efficient CPR.

Interventions that could improve survival rates include allowing paramedics privilege to an elevator access key as firefighters have; alerting building staff of the emergency before paramedics arrive to ready building access; and finally better placement of automated external defibrillators (AEDs) to maximise their use by bystanders.

Because the presence of a shockable heart rhythm decreases rapidly in 10 minutes following cardiac arrest, the use of an AED by another resident is key in saving someone’s life. Improving access by placing AEDs on higher floors, in the lobby, or inside elevators are key steps in improving survival rates. Better education to the public in responding to cardiac arrest is also recommended.

Journal Reference

IR Drennan, R P. Strum, A Byers, JE. Buick, S Lin, S Cheskes, S Hu, LJ. Morrison(2016) “Out-of-hospital cardiac arrest in high-rise buildings: delays to patient care and effect on survival”. CMAJ.

To find out more about renting an AED click here.

It’s ludicrous that state and national health campaigns have pushed safe driving initiatives and managed to reduce road fatalities significantly, but the same support is not given to sudden cardiac arrest where deaths are 10 times more likely than from road accidents. We are also 600 times more likely to die from a cardiac arrest than from a fire and yet fire extinguishers and fire alarms are mandated and installed everywhere.

The first step in turning these figures around is for automated external defibrillators (AEDs) to become common place in our community.

Tokyo has 40,000 AEDs installed around the city with 350,000 across Japan. And some local governments are financing and installing AEDs in convenience stores with 90% roll-out in some prefectures.

AEDs are located in some vending machines in Japan

Despite the growing abundance of AEDs in this country, Japan’s survival rates are as low as NSW. And this comes down to people being scared to use them. Dr. Kensuke Igarashi developed a smartphone app to connect people who know how to provide CPR  with those in emergency situations of help.

SOS smart phone app alerts those nearby with CPR skills

All of this leads to the second critical point that:

The community needs better education about providing resuscitation skills and that AEDs are nothing to be afraid of.

There is a real fear amongst individuals and organisations for being accountable for somebody’s death if they install and/or use an AED unsuccessfully. However, the fear is misguided. Someone will certainly die from cardiac arrest if they are not treated in 10 minutes, whereas they have a good chance of survival with defibrillation administered. To date there are no known cases of someone being held liable for using an AED in Australia.  Most states have “Good Samaritan” legislation protecting the untrained rescuer from lawsuits when acting in good faith.

Finally, the third crucial step to improving our rates of survival in NSW is:

To be a part of the National St John’s AED registry.

If you buy an AED be sure to register on the official site called Register my AED. Having a national registry is the reason Seattle and the the Netherlands have much higher rates of survival than us. The registry allows 000 operators to notify a caller where the nearest AED is, potentially saving someone’s life in minutes.