Apartment buildings and hotels
A building decides how long it takes to reach someone whose heart has stopped.
ERPVE measures the internal response route, identifies avoidable delay and certifies buildings that meet objective readiness criteria.
What this is about
Cardiac arrest is one of the few emergencies that anyone present can treat.
The heart stops pumping. Collapse is immediate, and the person stops responding or breathing normally.
More detail
A heart attack is a blocked artery in a person who is usually still conscious and can describe what is wrong. This is the pump stopping, and there is nothing to describe. Nothing announces it beforehand, so no building gets advance notice. Most cases happen outside hospital, and a large share of those happen where people live and sleep.
Compressions buy time. A defibrillator analyses the rhythm and guides the user aloud.
More detail
Compressions keep blood moving until a defibrillator can be applied, and they need to start within minutes of collapse. Where the person who finds the patient has no training, the emergency call handler talks them through it. Compressions done imperfectly are worth far more than compressions not done at all.
A defibrillator carries a diagram showing where the pads go, for men, women and children. It reads the heart rhythm itself, decides whether a shock would help, and says out loud what to do next. These devices are built so that a person who has never seen one can use it.
Entrance, lift, floor, unit and cabinet: every obstruction inside the property adds time.
More detail
Ambulance services handle everything that ends at the address. After that it is the entrance, the lift, the floor, the unit and the cabinet, and none of those are under the control of the crew standing outside.
On paper that stretch is short. In practice it is a locked lobby, a lift sitting on the eleventh floor, a numbering scheme that does not match the intercom, and a device that only the day-shift supervisor has the key to.
What is known
Most buildings that come out badly already own a defibrillator.
Absence is rarely the finding. What the research keeps showing is that the device exists and the system around it does not.
Of 23,619 public defibrillators inspected over five years in Seoul, 15.4% were not ready to use: flat battery, a fault, or missing or expired electrodes.1
In the same inspection, 44.1% could not be used around the clock. Access, not ownership, was the limiting factor.1
Survival from a shockable arrest falls by roughly 7 to 10% per minute before defibrillation. With bystander compressions the decline slows to about 3 to 4%.3
Where trained staff on site delivered the shock within three minutes of a witnessed arrest, 74% survived, against 49% when it came later.4
Sources 1 to 5 are listed under method and limits. These findings come from public-access and out-of-hospital settings in other countries. They establish which factors matter, not what any particular building's numbers would be.
How this works
Start with a check. Add evidence when you need it.
Move from a self-reported snapshot to a detailed assessment and, when useful, physical verification and certification.
Readiness check
Ten questions, about two minutes, answered from what you already know. "Not sure" is a real answer here, and usually the most useful one.
The check is self-reported and can be repeated as often as you like, which is exactly why it proves nothing about a building to anybody else. Of the three steps below, only certification produces something you can show to a resident, an insurer or an authority.
Remote assessment
Your defibrillator register, access procedures and training records are reviewed against ERPVE:2026-v3 across six domains:
- 01Device operational readiness
- 02Placement and retrieval time
- 03Immediate responder capacity
- 04Vertical access and patient location
- 05Ambulance entry and internal access
- 06Governance and continuity
- Based on
- Documents you supply, reviewed by ERPVE
- You receive
- A complete, detailed current-situation assessment report and a prioritised roadmap with clear improvement instructions. Per domain it records strengths, weaknesses, gaps, findings, the current score, and what is needed to reach certification grade or move up a tier.
- Costs
- Fixed fee plus a variable component based on area, floors and number of units. Portfolio bulk rates are available.
- Use it for
- Internal decisions, budget requests, a scope of work for quotes
- Not for
- Public claims about the building. Nothing has been verified on site.
Certification
Somebody walks the building and times the route. Bronze, Silver and Gold set progressively stricter requirements for coverage, named roles, access procedures and continuity. Annual, and it lapses if it is not renewed.
- Based on
- Physical verification on a named date
- Costs
- Quoted after the assessment
- Use it for
- Owners' meetings, tender responses, resident and tenant communication
- What it states
- Which criteria were met on the date of review. It does not guarantee the outcome of any emergency, and no assessment can.
Cost
A transparent formula, tailored to the property.
Every quote combines a fixed assessment fee with a variable component based on the scale and complexity of the building.
What the assessment produces
ERPVE is new as a company and few buildings have been through the criteria yet. Early properties are priced accordingly and get more attention than later ones will, and you should know that before you decide.
The subject matter is not new. Assessments are carried out by Stijn Hoekstra, who spent close to a decade inside HartslagNu, the Dutch national citizen-responder system, working on response logic, defibrillator visibility and volunteer activation. ERPVE is strictly evidence based and backed by scientific literature. Where the evidence does not support a requirement, the criteria do not contain one.
Why nobody has checked this before
Cardiac readiness falls between the frameworks that already inspect your building.
Existing systems inspect the building. None of them measures the complete internal cardiac-arrest response path, so where no requirement exists there is also no benchmark, and every owner sets their own standard by default.
International ratings may check whether a defibrillator programme exists. They do not require anyone to time the route to the top occupied floor or test overnight access.
Fire evacuation moves people outward over many minutes. A cardiac arrest sends one responder inward and upward immediately, and the arrangements that serve the first do not serve the second.
Questions
The things people ask before they reply.
We already have a defibrillator. What would an assessment tell us?
Most buildings that score badly own one. The common findings are not absence but availability: pads past their expiry date, a cabinet locked outside office hours, a device four floors and two locked doors from where somebody collapsed, and nobody rostered overnight who knows it is there.
The readiness check above will show within two minutes which of those you can answer and which you cannot. The questions you cannot answer are the finding, because during an emergency you would be in exactly that position.
Our building already holds an international health and safety rating.
Those schemes ask whether a defibrillator programme is documented and whether devices are present. They are satisfied by policy rather than by measurement, and nothing in them requires anyone to walk the route from the device to the top occupied floor and record how long it took.
There is a second effect worth thinking about. A rating displayed in a lobby is read by residents as a statement about their safety, and what it certifies is not inspected against what happens during an emergency. If a building is going to make that impression, it is worth knowing whether the arrangements behind it would hold.
Where a rating is already held, the sensible product is a gap audit against ERPVE:2026-v3 rather than a full assessment, priced as the smaller piece of work it is.
We would rather wait until this is required.
That is a defensible position for a cost that only ever arrives once. This one does not work that way. The register, the access procedure and the roster entries take time to assemble, and a building that starts when a requirement lands is starting from the same blank page it has today.
The readiness check costs nothing and takes two minutes, so the cheapest version of waiting is knowing what you would be starting from.
How often does this actually happen in a building like ours?
Nobody can tell you. The UAE has no national out-of-hospital cardiac arrest registry and no public dataset linking incidents to building addresses, so any rate quoted for your portfolio would be borrowed from another country and presented as local.
What the readiness check produces is the first documented data point for your own property: how long the route takes, and where it stalls. That is a smaller claim than a survival statistic, and it is one that holds up in a board paper.
Do we have to buy equipment from you?
No. ERPVE can source devices if that is useful, but nothing about a finding, a score or a certification decision depends on where equipment comes from, and no commission is received from any manufacturer, distributor or maintenance contractor.
Where an action requires equipment, the report states the specification needed and leaves the purchase to you.
Who sees our answers and our documents?
Answers to the readiness check are recorded so the result can be produced and emailed where you ask for it. Documents supplied for an assessment are used to carry out that assessment and to keep the resulting record.
No property is named publicly without written permission, nothing is sold to third parties, and deletion requests are honoured. Certification is the only output intended to be shown outside your organisation, and even then only what you choose to show.
Contact
Ask a question, or request a quote for a specific property.
Replies come from Stijn Hoekstra, usually within one working day. Nothing is added to a mailing list, and no call is scheduled unless you ask for one.
Method and limits
What the floor data actually shows, and what it does not.
Drennan and colleagues examined 7,842 out-of-hospital cardiac arrests in private residences in Toronto and Peel Region between 2007 and 2012, comparing survival to hospital discharge by the floor the patient was on. The chart at the top of this page is drawn from those figures.
Survived below the third floor. 252 of 5,998 cases.
Survived on or above the third floor. 48 of 1,844 cases, and the band most buildings assessed under ERPVE sit in.
Survived above the sixteenth floor, which is 2 of 216 cases. Of the 30 arrests above the twenty-fifth floor, none survived.
The authors attribute the pattern to the time taken to reach the patient after the ambulance arrives. Time is one factor among several, and the study does not establish that a shorter internal route would have changed any individual outcome. It describes a population in one region during one period, in a health system with its own response times and building stock.
Read the case numbers alongside the percentages. The three groups above are nested rather than separate: the higher-floor figures sit inside the third-floor-and-above group, and the number of cases falls steeply toward the top. The 0.9% rests on two survivors, and the group above the twenty-fifth floor contains thirty cases in total.
The study reports floor bands rather than individual floors. The hero chart therefore uses a clearly labelled schematic curve through the reported band values. It is a visual guide, not a per-floor survival estimate.
The same caution applies to everything in the section above. Those findings come from public-access and out-of-hospital settings in South Korea, Denmark, Canada and the United States. They establish which factors matter, and they do not predict what a specific building in the UAE would produce.
That gap is not incidental. The UAE has no national out-of-hospital cardiac arrest registry and no public dataset linking incidents to building addresses, so there is no local denominator to compare against. An assessment produces a measurement for one property, which is a smaller claim than a survival rate and a more defensible one.
1. Kim et al., Trends in maintenance status and usability of public automated external defibrillators during a 5-year on-site inspection, Scientific Reports, 2022. 23,619 devices inspected in Seoul, 2013 to 2017. Open
2. Hansen et al., Automated external defibrillators inaccessible to more than half of nearby cardiac arrests in public locations during evening, nighttime, and weekends, Circulation 128(20), 2013.
3. Larsen et al., Annals of Emergency Medicine, 1993; Valenzuela et al., 1997. The range is widely cited in AHA and ERC guidance and describes witnessed shockable arrests.
4. Valenzuela et al., Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos, New England Journal of Medicine 343(17), 2000.
5. Sun et al., Effect of optimized versus guidelines-based automated external defibrillator placement on out-of-hospital cardiac arrest coverage: an in silico trial, JAHA, 2020. Open
6. Drennan et al., Out-of-hospital cardiac arrest in high-rise buildings: delays to patient care and effect on survival, CMAJ 188(6), 2016. Open
Privacy. Answers to the readiness check are recorded so the result can be produced and, where you ask for it, emailed to you. Information sent to ERPVE is used to answer an enquiry, run a requested check or assessment, and keep the resulting records. No property is named publicly without written permission, and ERPVE does not sell submitted information. Deletion requests go to stijn@erpve.org.
Scope. The readiness check is self-reported, is not verified, and is not a certification assessment, medical advice or an emergency response service. Certification records which criteria were met on the date of review. It does not guarantee the outcome of a cardiac arrest or any other emergency.