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Until now, the survival outcome from “vertical delay to patient contact” was largely unknown.

Cardiac arrest isn’t the same as a heart attack. Cardiac arrest occurs when electrical impulses in the heart become rapid or chaotic, causing the heart to suddenly stop beating. A heart attack results when blood supply to a part of the heart is blocked, though it can lead to a lethal rhythm, and cardiac arrest. According to the Heart and Stroke Foundation, only five per cent of Canadians survive a cardiac arrest outside hospital.

Cardiac arrest can be reversed if CPR is performed and a defibrillator used to shock the heart into a normal rhythm. But the chance of surviving decreases by about 10 per cent for every one-minute delay to defibrillation and CPR.

In the Toronto study, it took paramedics a mean of 4.9 minutes to reach people on the third floor or higher, compared to three minutes for those below the third floor.

What’s more, a smaller proportion of people on the higher floors still had a shockable rhythm by the time paramedics arrived.

“This is something people often think about when they get out to rural settings — ‘OK, it’s going to be a bit of a delay for help to get here if I need it,’” Drennan said. “But people in high-rises think, ‘well, I’m still within the city so I should be OK.” There is a little bit of a delay that I think people should be aware of.”

It’s pretty well shown throughout the literature that bystander CPR can almost double survival from cardiac arrest in some situations

One of the biggest barriers is elevator access. Drennan knows firsthand what it’s like to press the “up” arrow and have to watch the elevator come down from the 30th floor. Fire departments have a universal elevator key, giving them sole access to elevators. Paramedics almost never do. “Availability of a universal key seems like a simple intervention, but it has remained unaddressed for decades,” the team writes in the CMAJ.