The adult cardiac arrest algorithm is the most important algorithm for adult resuscitation. Unless you can quickly identify and treat the cause of pulseless electrical activity, the rhythm will likely deteriorate to asystole. Treatment for Pulseless Electrical Activity (PEA) However, in PEA, there is no pulse with orderly cardiac electrical activity similar to normal sinus, which is not a typical cardiac arrest ECG rhythm like asystole (seen as a flat line on the monitor), ventricular fibrillation, or ventricular tachycardia. The absence of a patient’s pulse confirms a clinical diagnosis of cardiac arrest. Diagnosis of Pulseless Electrical Activity (PEA)Īn ECG/EKG is capable of distinguishing pulseless electrical activity from other causes of cardiac arrest. They can also check for heart sounds by using a stethoscope for no more than 10 seconds. The skin may appear pallor due to a lack of oxygen in the blood.ĪCLS providers should make sure to check for a pulse at the carotid artery. Pulseless electrical activity leads to a loss of cardiac output and discontinues blood supply to the brain. Signs and Symptoms of Pulseless Electrical Activity (PEA)Ī patient with PEA will be unconscious with no pulse or normal breathing. Rather than merely reacting to and relying on the rhythms that are being displayed on the ECG monitor. For this reason, treating the patient’s symptoms, particularly when it comes to pulseless electrical activity, is vitally important. The ECG interpretation for a patient exhibiting signs of PEA could be the same as normal sinus rhythm. It’s important to rule out any of the treatable H’s and T’s as underlying causes for pulseless electrical activity to correct the mechanical disassociation that could be causing the patient’s cardiac arrest. Underlying and treatable causes for pulseless electrical activity include: It’s always important to treat the patient’s symptoms, rather than rely on the ECG readout alone. Causes of Pulseless Electrical Activity (PEA) PEA can be caused by reversible conditions easily remembered as the H’s and T’s, which you’ll see below. When a patient is in PEA, the ECG monitor can display normal or wide QRS complexes, as well as other abnormalities, which include:ĪCLS providers must remember to assess the patient’s monitored rhythm and note the rate and width of the QRS complexes. Very slow pulseless electrical activity can also be referred to as agonal. The rate of electrical activity may be slow (which is most common), normal, or fast. Pulsations can be detected by an arterial waveform or Doppler study. Instead, it’s a term used to describe any organized electrical activity – but excluding VFib or asystole - on an ECG or cardiac monitor that is associated with no palpable pulses. Pulseless electrical activity is not a specific rhythm. Healthcare providers need to find the potential cause and correct it, which will hopefully restore the patient’s pulse. Pulseless electrical activity, also commonly referred to as PEA, is a condition where the electrical activity of the heart isn’t accompanied by a palpable or effective pulse. Prev 1 of 1 Next What is Pulseless Electrical Activity (PEA)?
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