Recognizing Preterminal Signs

Once cardiac arrest has occurred, the chances for neurologically intact recovery dramatically decline. While some types of cardiac arrest, mostly those of arrhythmogenic origin, can hardly be foreseen, the majority of cardiac arrests are preceded by clinical signs indicating the nearing cardiovascular collapse. In most patients, cardiac arrest is the final pathway of a gradual progression of symptoms. There are no clear cut-off values of such preterminal signs but rather an insidious trend of symptoms. It is essential to recognize these clinical signs as all of them must be addressed timely and adequately. A summary of clinical signs commonly preceding cardiac arrest is shown in Table 4.1.