Improving odds in highrises
Experts set on increasing the rate of survival in skyscrapers
Tony Fagan died precisely the same way his mom did many years earlier: from cardiac arrest after doing laps in a pool. Both were rushed to St. Paul’s Hospital, except Fagan was successfully resuscitated by paramedics within three minutes of his heart stopping. En route to the hospital, paramedics actually shocked his heart numerous times to restart it.
The Lafarge concrete-truck operator — now on medical leave — says in the minutes before his heart stopped, he was hyper-aware of what he needed to do to improve his odds of survival. Instead of waiting in his 23rd-floor condo, he struggled through crushing chest pain to get himself to the lobby where he knew paramedics would find him faster. For a moment, he thought taking some Aspirins might be a good idea to improve blood circulation, but finding them in his condo meant adding minutes and all he could think about was a newspaper article he’d read in 2016, about a Canadian study that showed having a cardiac arrest anywhere above the second floor of a highrise adds two more minutes to emergency response time.
“I kept thinking about my mom who died on my 30th birthday. I knew I’d probably be going to the same hospital where she died after having open-heart surgery. I’ve always sailed through all my medical checkups so I never expected I’d died this way. But the irony that I could die after a swim, just like my mom, was not lost on me, even in my dying moments,” said Fagan, who had an emergency procedure by interventional cardiologists once he got to St. Paul’s — three stents placed in his blocked heart vessels.
“I died while sitting in my Yaletown lobby waiting for the ambulance after I called 911. I had emergency surgery by amazing doctors at St. Paul’s and when I was finally conscious, it was five days later,” recalls the 64-year old Fagan of the calamity he won’t even call a neardeath experience. “I was dead, let’s face it.” Just over 2,000 B.C. residents die from cardiac arrest each year. The vast majority (85 per cent) of cardiac arrests occur in homes and other places outside of hospital, so Fagan’s experience was quintessential. But since only about 10 per cent of individuals with cardiac arrest survive, Fagan’s outcome is more unique.
As the research Fagan recalled shows, if the heart stops beating in a highrise condo or other tall building, chances of survival are worse since it may be impossible for paramedics to reach patients within a three-minute window when the chance of resuscitation — and no brain damage — is greatest.
Brain damage begins within three to five minutes of cardiac arrest. According to B.C. Emergency Health Services, the average ambulance response time last year was 9:13 minutes. That’s impressive considering paramedics responded to 7,100 cardiac-arrest calls, almost twice as many as two years before when drug-overdose deaths (more than 1,000 in 2017) weren’t so ubiquitous. The chance of survival drops seven to 10 per cent for each passing minute after cardiac arrest.
After the pivotal Canadian study was published in the Canadian Medical Association Journal, health agencies began strategizing over ways to boost awareness and improved access to automated external defibrillators (AEDs) that are used to restart hearts. A public-awareness campaign, led by St. John Ambulance, will soon be launching in B.C. Getting more AEDs into skyscrapers and other buildings is the goal.
Dr. Garry Henderson, a Vancouver family medicine doctor who also does a few shifts each week as an emergency room physician at Mission Memorial Hospital, lives in the same 40-storey Yaletown building as his friend, Fagan. Even before Fagan’s cardiac arrest, Henderson was pushing the condo strata to acquire some AEDs. About three months after Fagan’s medical crisis, the AEDs were bought from St. John Ambulance for about $2,300 each.
Henderson, who had a heart attack while working in the hospital several years ago, says condo boards shouldn’t be “hemming and hawing” about having AEDs on-hand. “They’re so easy to use. The device basically coaxes you through the whole thing,” said Henderson, who volunteers his time to anyone who wants to know more about AEDs.