What is the greatest risk factor for having a heart attack, the nation’s No. 1 killer? Most people will say that it’s having high blood cholesterol, or hypertension, obesity, diabetes or a stressful lifestyle.
But suppose you ask what will improve the chance of surviving coronary attack. I’d predict that, after some hesitation, the answer will be having someone nearby to administer cardio-pulmonary resuscitation (CPR). But how many know that it depends on the floor you’re living on in a highrise building? And what should you know about the 26th floor?
I’ve been living for 35 years in a highrise condo in Toronto. But my wife and I never considered that whether we chose to have a view of Lake Ontario or the city might be a lethal decision. Now, a report in the Canadian Medical Association Journal by Ian R. Drennan, an advanced care paramedic, and his colleagues, says the floor you live on can be a matter of life or death.
Their study shows that more than 400,000 out-of-hospital cardiac arrests occur every year in North America, and, “in spite of continued attempts to increase resuscitation care, survival to hospital discharge in most communities remains below 10 per cent.”
“Rapid defibrillation and high- quality CPR are essential to survival, with an absolute decrease in survival of seven to 10 per cent for each minute of delay to defibrillation,” they write.
Today, and in the future, an increasing number of people will be living in highrise condos. For instance, over a five-year period in Toronto, there has been a 13 per cent increase in those living in highrises.
Moreover, 40 per cent of homeowners over 65 reside in highrise buildings, the very ones who are at higher risk of cardiac arrest. This will result in an increased number of 911 calls from highrise condos.
So what can go wrong? Drennan and his colleagues outline a number of obstacles, some just lacking in good sense.
For instance, the majority of studies consider the time it takes from the moment a 911 call is placed for help to arrive at a residence. But with a condo, ambulance paramedics and firefighters face either a flight of stairs or an elevator.
The journal reports that elevators pose a significant problem. Barriers to elevators are the main cause of delay. Elevators might be in the process of moving a new resident in, or moving one out. Or it may be rush hour in the early morning or late afternoon, causing an increase in wait times.
I found it disturbing to read that in 67 per cent of cases, the ambulance stretcher could not fit into the elevator. In a similar number of cases, an entry code was needed for access, or doors to the building were locked. A lack of directional signals occurred in 82 per cent of cases. Finally, no one was available to
quickly escort medical personnel to the patient.
So who survived? This is not a reassuring story. For those living below the third floor, the overall survival rate was 4.2 per cent. It was 2.6 per cent if you lived above this level. But suppose you had purchased a condo above the 25th floor with an eye-catching panoramic view of the city. At this high level, there were no survivors.
What’s the message? Life is a game of chance at any time and in any location. But this study shows you might pay a price for a lofty view — namely your life — when chest pain suddenly strikes.
So if you live in a high-rise condo, or plan on moving to one, find out the number of barriers that will delay first responders to your floor. See if there are any automated external defibrillators at specific locations nearby that would increase survival. Then learn how to use them. The study found that bystander use of the devices was low.
My floor number is not above the 25th. But I admit this was not good planning, just good luck.
