A15. Early warning signs and peri-arrest period

Peri-arrest and warning signs

The peri-arrest state is the state just before cardiac arrest, indicating the need for immediate intervention and/or preparation for CPR. It’s important to recognize so that CPR can be initiated early. A peri-arrest state occurs in 80% of cases before cardiac arrest.

The so-called “OMG” signs of peri-arrest:

• Respiratory rate > 30/min or < 8/min
• Heart rate > 140/min or < 40/min
• Systolic BP > 220 mmHg or < 90 mmHg
• GCS decrease by > 2
• Imminent airway obstruction (decrease in SpO2)

Other important signs of peri-arrest:

• Seizure
• Asystolic periods (> 2 – 3 seconds)
• Acute significant bleeding
• Any unexplained deterioriation

Immediately perform ABCDE management. Secure airways and breathing, monitor and support circulation, check for disabilities and exposure/environment.