High-Rise, High Risk: Why Cardiac Arrest Survival Drops with Elevation

Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death worldwide. When it happens, survival depends heavily on early intervention—especially CPR and defibrillation. But what if cardiac arrest strikes 20 floors above ground level?

In modern cities like Canberra, more people are living in high-rise buildings. Yet around 80% of cardiac arrests happen in the home, meaning most cases occur in residential settings—not in public spaces. That means residents of high-rise buildings are uniquely vulnerable.

The Higher You Live, The Lower the Survival Rate

A major study published in the Canadian Medical Association Journal found that

1. Survival to hospital discharge was 4.2% below the 3rd floor but just 2.6% above the 3rd floor.

2. Survival on or above the 16th floor dropped to 0.9%

3. There were no survivors above the 25th floor.

These alarming statistics underline the risks of delayed medical response in vertical environments—something residents and property managers in Canberra must consider seriously.

Vertical Delays Cost Lives

When emergency medical services arrive at a high-rise, they often face delays such as:

1. Waiting for elevators

2. Locating the correct unit

3. Transporting stretchers in narrow halls or stairwells

   
   

In one study, high-rise patients took 2–3 minutes longer to reach than those in low-rise homes. While that may not sound like much, every minute without CPR or defibrillation decreases survival by up to 10%. These delays are why we strongly recommend CPR and First Aid Training for building residents.

Neurological Outcomes and Difficult Extrication

Survival is just one part of the picture. For those who are revived, the goal is a favourable neurological outcome—that is, waking up with full brain function.

Unfortunately, studies show that as the difficulty of removing a patient from a high-rise increases, the chances of a good neurological recovery drop. This is due to:

1. Interruptions in CPR during stair or elevator transport

2. Delayed access to defibrillation

3. Longer low-perfusion periods (reduced oxygen to the brain

   
   

This makes it even more essential for bystanders to begin CPR immediately and use an AED if available—well before paramedics arrive.

The Importance of AEDs and Bystander First Aid Training

In the Toronto study, an AED was applied by a bystander in fewer than 0.5% of cases. That's a major missed opportunity, given that early defibrillation drastically improves survival and neurological outcomes.

If you live in or manage a high-rise in Canberra, here’s what you can do:

1. Install an AED in your building: Place it in a visible, accessible area like the lobby or every third floor.

2. Organise First Aid Training in Canberra: Encourage residents to take CPR and AED courses. We offer tailored First Aid Canberra programs for a wide range of audiences. This includes:

   1. Essentials Course

   2. HLTAID009 Provide CPR

   3. HLTAID011 Provide First Aid

   4. Baby Talk - Baby First Aid

3. Create a building emergency plan: Ensure responders can access elevators, unlock doors, and find the patient fast.

Final Word: Be Prepared Where You Live

Most cardiac arrests happen at home—and in high-rise apartments, delayed response can be deadly. Whether you're a resident, building manager, or strata committee member, your action can be the difference between life and death.

Contact Paramount First Aid to arrange Canberra First Aid Training or equip your building with an AED. Together, we can make our vertical communities safer, stronger, and more prepared.