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.