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Living in a high-rise building can offer spectacular views of cityscapes and quiet separation from the bustle below. But one trade-off may be reduced chances of surviving a medical emergency. A new study found that residents of higher floors had higher death rates of cardiac arrest than those that lived near ground level.

To reach that conclusion, researchers examined the records of 7,000 Toronto-area residents who suffered cardiac arrests in the home, and who were reached by first responders after a 911 call.


Cardiac arrest has a low survival rate as it is. Only 3.8 percent of the people studied survived to be discharged from the hospital. But the survival rate was higher — 4.2 percent — for people living below the third floor. Above the third floor, only 2.6 percent survived. That dropped to 1 percent above the 16th floor, and none above the 25th floor, researchers reported Monday in the Canadian Medical Association Journal.

To blame, the authors said, is paramedics’ delay in reaching patients on higher floors. On lower floors it took just a few minutes, but that lengthened to near five minutes for patients above the third floor.

They proposed a simple change that could make a big difference: giving paramedics a key to override the elevator, so they aren’t stopping at floors on the way up. Firefighters carry a universal elevator key, but paramedics often don’t. “Availability of a universal key seems like a simple intervention, but it has remained unaddressed for decades,” the authors wrote.


Building owners and managers should also place defibrillators in their buildings, they said, so bystanders can give initial treatment.

One city that is taking this to heart is Singapore, which has 74 buildings that are over 500 feet (or roughly 50 stories) high. The city has a public campaign underway to train 1 million people in resuscitation and defibrillator use, and to enroll residents’ committees as first responders in their buildings.