Out-of-hospital cardiac arrest in high-rise buildings: delays to patient care and effect on survival

To the Editor,

I read with great interest the article on out of hospital cardiac arrest (OHCA) by Drennan et al. in the April issue of CMAJ (1). This article underscores the importance of social determinants of health of which housing is also an important determinant(2).As a Public health student it is a validation of the fact that concepts learnt in class have so many applications in real life.

I would like to highlight to the esteemed authors about the importance of social support networks which is also a key social determinant of health(2). According to Sasson et al.(3), targeted Cardiopulmonary resuscitation (CPR) training to increase bystander CPR rates can be an effective tool to counter the time lag of Emergency Medical support services. Importance of community members in delivering time efficient CPR is also noted by Mcnally et al(4).

Also your results about relevance of floor of residence in buildings for people with a cardiac history could be an important component when an apartment is rented or bought or leased. For eg: if a person shares their cardiac history when buying, renting or leasing their apartments it could be linked to a cardiac arrest surveillance registry and a copy could be sent to a neighborhood watch committee.

This sort of public health application into social sphere of life could be an important key factor in preventing undesirable health outcomes.

References

1. Drennan, I. R., Strum, R. P., Byers, A., Buick, J. E., Lin, S., Cheskes, S., ... & Rescu Investigators. (2016). Out-of-hospital cardiac arrest in high-rise buildings: delays to patient care and effect on survival. Canadian Medical Association Journal, cmaj-150544.

2. Mikkonen, J., & Raphael, D. (2010). Social determinants of health: The Canadian facts. York University, School of Health Policy and Management.

3. Sasson, C., Rogers, M. A., Dahl, J., & Kellermann, A. L. (2010). Predictors of survival from out-of-hospital cardiac arrest a systematic review and meta-analysis. Circulation: Cardiovascular Quality and Outcomes, 3(1), 63-81.

4. McNally, B., Robb, R., Mehta, M., Vellano, K., Valderrama, A. L., Yoon, P. W., ... & Kellermann, A. (2011). Out-of-hospital cardiac arrest surveillance-Cardiac Arrest Registry to Enhance Survival (CARES), United States, October 1, 2005-December 31, 2010. MMWR Surveill Summ, 60(8), 1-19.

Conflict of Interest:

None declared