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. 2021 Oct 13;10(20):4684.
doi: 10.3390/jcm10204684.

Cardiac Arrest Occurring in High-Rise Buildings: A Scoping Review

Ming Xuan Han  1 , Amelia Natasha Wen Ting Yeo  2 , Marcus Eng Hock Ong  3   4 , Karen Smith  5 , Yu Liang Lim  1   6 , Norman Huangyu Lin  6 , Bobo Tan  1 , Shalini Arulanandam  1 , Andrew Fu Wah Ho  3   4 , Qin Xiang Ng  1   6
Affiliations

Cardiac Arrest Occurring in High-Rise Buildings: A Scoping Review

Ming Xuan Han et al. J Clin Med. .

Abstract

Out-of-hospital cardiac arrests (OHCAs) occurring in high-rise buildings are a challenge to Emergency Medical Services (EMS). Contemporary EMS guidelines lack specific recommendations for systems and practitioners regarding the approach to these patients. This scoping review aimed to map the body of literature pertaining to OHCAs in high-rise settings in order to clarify concepts and understanding and to identify knowledge gaps. Databases were searched from inception through to 6 May 2021 including OVID Medline, PubMed, Embase, CINAHL, and Scopus. Twenty-three articles were reviewed, comprising 8 manikin trials, 14 observational studies, and 1 mathematical modelling study. High-rise settings commonly have lower availability of bystanders and automatic external defibrillators (AEDs), while height constraints often lead to delays in EMS interventions and suboptimal cardiopulmonary resuscitation (CPR), scene access, and extrication. Four studies found return of spontaneous circulation (ROSC) rates to be significantly poorer, while seven studies found rates of survival-to-hospital discharge (n = 3) and neurologically favourable survival (n = 4) to be significantly lower in multistorey settings. Mechanical chest compression devices, transfer sheets, and strategic defibrillator placement were suggested as approaches to high-rise OHCA management. A shift to maximising on-scene treatment time, along with bundling novel prehospital interventions, could ameliorate some of these difficulties and improve clinical outcomes for patients.

Keywords: cardiac arrest; cardiopulmonary resuscitation; high-rise; residential; urban.

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Conflict of interest statement

Lim, Lin and Ng are employees of MOH Holdings Pte Ltd. (MOH Holdings is the holding company for Singapore’s public healthcare institutions; MOH Holdings Pte Ltd. was not involved in the writing or preparation of this manuscript). The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart illustrating the study selection process.
Figure 2
Figure 2
Geographical distribution of studies included in this review.
See this image and copyright information in PMC

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