Emergency workers are pulling people from high-rise buildings left tilting at extraordinary angles after a major earthquake struck Taiwan.

At least six people are dead, 76 missing and 256 injured following the 6.4-magnitude tremor, which hit 13 miles north-east of Hualien, a city on the east coast of the country, on Tuesday night.

Another, less powerful earthquake had struck a few hours earlier.

Video footage showed children being passed out of several buildings in Hualien county leaning at sharp angles, their lowest floors crushed into mangled heaps of concrete, shattered glass, bent iron beams and other debris.

Firefighters could be seen climbing ladders, ropes and cranes as they sought to reach adults and children trapped inside apartments.

A maintenance worker who was rescued after being trapped in the basement of the Marshal Hotel, whose ground floor had caved in, said the force of the earthquake was unusual.

Taiwan hotel looks set to collapse after 6.4 magnitude earthquake

“At first it wasn’t that big... we get this sort of thing all the time and it’s really nothing. But then it got really terrifying,” the worker, Chen Ming-hui, told Taiwan’s official Central News Agency (CNA) after he was reunited with his son and grandson following the quake. “It was really scary.”

Two employees at the hotel were killed in the disaster, CNA said. Taiwan’s National Fire Agency said rescuers freed another employee from the rubble.

At least four buildings caved in and shifted on their foundations. This was likely caused by soil liquefaction, when the ground beneath a building loses its solidity under stress such as that caused by an earthquake.

The force of the tremor buckled roads and disrupted electricity and water supplies to thousands of households, the fire agency said.

Japan‘s Foreign Ministry said nine Japanese were among the injured. CNA reported 16 foreigners were sent to various hospitals with injuries.

Taiwan earthquake damage: in pictures Show all 10 1 /10 Taiwan earthquake damage: in pictures Taiwan earthquake damage: in pictures Rescue workers walk out from the Yun Tsui building, which is leaning at a precarious angle, in the Taiwanese city of Hualien on February 8, 2018 after the city was hit by a 6.4-magnitude quake late on February 6. AFP/Getty Images Taiwan earthquake damage: in pictures A child rides a bicycle on a fractured road in Hualien. REUTERS Taiwan earthquake damage: in pictures Rescuers rushs against time to search for survivors from thr damaged building in Hualien on 6 February, 2018. EPA Taiwan earthquake damage: in pictures People pray for the earthquake victims outside a damaged building. Getty Images AsiaPac Taiwan earthquake damage: in pictures Displaced families take shelter in a school . AFP/Getty Images Taiwan earthquake damage: in pictures A resident walks past a damaged street in Hualien. EPA Taiwan earthquake damage: in pictures A rescue worker takes a photo of the Yun Tsui building. AFP/Getty Images Taiwan earthquake damage: in pictures Taiwanese rescuers continued the terrifying task on February 8 of searching for survivors in a dangerously leaning apartment block that was partially toppled by an earthquake, despite regular aftershocks coursing through the building's tottering structure. EPA Taiwan earthquake damage: in pictures The Yun Tsui building. REUTERS Taiwan earthquake damage: in pictures Rescuers carry a body from the damaged building. EPA

Taiwanese president Tsai Ing-wen moved to reassure the public that every effort would be made to look for survivors. In a post on her official Facebook page, Ms Tsai said she arrived in Hualien on Wednesday to review rescue efforts.

Ms Tsai said she “ordered search and rescue workers not to give up on any opportunity to save people, while keeping their own safety in mind”.

“This is when the Taiwanese people show their calm, resilience and love,” she wrote. “The government will work with everyone to guard their homeland.”

China‘s official Xinhua News Agency reported that the director of China’s Taiwan Affairs office, Zhang Zhijun, said China was “willing to send a rescue team to Taiwan” to help with relief efforts, adding that he was aware of a shortage of rescue workers in the disaster area.

China Central Television reported that more than 40 of the missing people were trapped in the Yunmen Cuiti building, a 12-story apartment block left tilting at a near 45-degree angle. Emergency services erected long steel beams to prevent it from collapsing.

Taiwanese media reported that the Beautiful Life Hotel was also tilting.

CNA posted photos showing a road fractured in several parts. Bridges and some highways were closed pending inspections.

With aftershocks continuing to hit after the quake, residents were directed to shelters, including a newly built baseball stadium, where beds and hot food were provided.

Speaking from a crisis centre in Taipei, cabinet spokesman Hsu Kuo-yung said rail links appeared to be unaffected and the runway of Hualien airport was intact.

“We’re putting a priority on Hualien people being able to return home to check on their loved ones,” Mr Hsu said.

The US Geological Survey said the quake struck just before midnight on Tuesday about 21km (13 miles) north-east of Hualien at a relatively shallow depth of about 10.6km (6.6 miles).

Taiwan has frequent earthquakes due to its position along the Ring of Fire – the seismic faults encircling the Pacific Ocean where most of the world’s earthquakes occur.

Exactly two years earlier, a magnitude 6.4 quake collapsed an apartment complex in southern Taiwan, killing 115 people. Five people involved in the construction of the complex were later found guilty of negligence and given prison sentences.

A magnitude 7.6 quake in central Taiwan killed more than 2,300 people in 1999.