A lower chance of survival, the higher up you go.
As the number of individuals living in lofty high-rises increases, so too does the number of emergency calls to these same high-rises. As a result of this, emergency personnel are now having to deal with navigating these large elevated residences and dealing with the challenges that are presented to them.
As they traverse the already lengthy hundreds of feet between their emergency response vehicle and the person who is in need of aid; emergency responders potentially have to deal numerous issues. Just a few of these common issues include: elevator malfunctions or delays, blocked accessways, and complicated building layouts.
A large portion of the population that is at risk for severe medical conditions is individuals over the age of 65. When combined with living in high-rises, this information is even more dire. In Toronto, Canada alone, over 40% of individuals over the age of 65 live in high-rise homes.
Just How Bad Is It
In North America, each year at least 400,000 cardiac arrests take place outside of a medical facility (at home, at work, etc.).
Research published in the Canadian Medical Association Journal found that once an individual is situated on the third floor or above; their survival rate, in the event of cardiac arrest, was seriously lowered. Even worse, research also found that once the 16th floor was passed, the chance for survival was negligible.
While this may sound scary, it is the harsh reality presented by the facts. Cardiopulmonary resuscitation (CPR) and rapid defibrillation are necessary when a cardiac arrest occurs. In fact the overall chance of survival plummets by at as much as ten percent for every minute that defibrillation is delayed.
Studies in the past have measured and calculated response times between the actual arrival of the emergency personnel on site and the initial 911 calls that were made. The problem is, that in most cases people misjudge the amount of time required to actually reach the patient once emergency responders have made it to the location; in this case high-rises. This period of time can extend for as much as four minutes – over a quarter of the total time between actually making contact with the patient and the initial 911 call.
What are the reasons for this extended delay? Over 80% of calls were hindered by substandard signage; and over 30% were impeded by access barriers. Irritatingly, over 60% of calls required a security code or entry code, which caused delays for up to a minute at times. Even things as simple as elevator stops delayed calls anywhere between 30 seconds to a minute.
In a research that was conducted in Toronto, in regards to survival after cardiac arrest and the floor of patient contact; Ian Drennan, et al., found that survival rates were indeed linked to distance.
In a sample size of 8216 persons who suffered from cardiac arrest and were treated by emergency responders in private dwellings, only 3.8% survived to be transported to the hospital. Out of the approximately 6000 persons living below the third floor, 4.2% (252) survived. Once the third floor was passed then the survival rate plummeted. At or above the third floor out of the 1844 persons, 2.6% (48 survived.); and above the 16th floor out of the 216 persons, 0.9% (2) survived. None of the 30 individuals who had cardiac arrests above the 25th floor survived.
To quote Drennan on this: “As the number of high-rise buildings continues to increase and as population density rises in major urban centers, it is important to determine the effect of delays to patient care in high-rise buildings on survival after cardiac arrest.”
As larger portions of the population start to move vertically when looking for homes, emergency response times (especially in cases of cardiac arrest) become much more important.