Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and the lack of a palpable pulse in the presence of organized cardiac electrical activity. Pulseless electrical activity has previously been referred to as electromechanical dissociation (EMD). (See Etiology.)
What is the difference between PEA and asystole?
Asystole is the flatline reading where all electrical activity within the heart ceases. PEA, on the other hand, may include randomized, fibrillation-like activity, but it does not rise to the level of actual fibrillation.
What happens during PEA?
Pulseless electrical activity (PEA) occurs when a major cardiovascular, respiratory, or metabolic derangement results in the inability of cardiac muscle to generate sufficient force in response to electrical depolarization.
Is PEA shockable?
Two-thirds of OHCA has an initial non-shockable rhythm of PEA or asystole with an increasing incidence compared with initial shockable rhythms (ventricular fibrillation and pulseless ventricular tachycardia). Several studies have shown the incidence of PEA in-hospital to be approximately 35% to 40% of arrest events.
How is PEA diagnosed?
As a result, PEA is usually noticed when a person loses consciousness and stops breathing spontaneously. This is confirmed by examining the airway for obstruction, observing the chest for respiratory movement, and feeling the pulse (usually at the carotid artery) for a period of 10 seconds.
What is the treatment for PEA?
PEA is not a shockable rhythm and treatment for PEA involves high quality CPR, airway management, IV or IO therapy, and appropriate medication therapy. The primary medication is going to be 1mg epinephrine 1:10,000 every 3-5 minutes rapid IV or IO push.
Can PEA look like NSR?
Pulseless Electrical Activity (PEA) Diagnosis
An electrocardiogram (ECG/EKG) device is capable of distinguishing PEA from other causes of cardiac arrest. The ECG interpretation can appear the same as a normal sinus rhythm.
Why is PEA not a shockable rhythm?
Because a Pseudo-PEA may be shockable because it’s probably one of the three shockable rhythms. But depending on the devices used to determine “pulselessness”, one might falsely determine a PEA arrest and not shock.
What are the 4 shockable rhythms?
Shockable rhythms are rhythms that are caused by an aberration in the electrical conduction system of the heart.
Ventricular Tachycardia. Kathawala S. EMS rhythm strip. Ventricular Fibrillation. Goldberger A, Goldberger Z, Shvilkin A. Ventricular fibrillation. Supraventricular Tachycardia. Jones C. Sudden onset SVT.
What are causes of PEA?
The causes of PEA are divided into primary (cardiac) and secondary (noncardiac) causes. Primary PEA, associated with cardiac arrest, is due to depletion of myocardial energy stores and responds poorly to therapy. Drugs used to treat primary PEA include epinephrine, atropine, calcium, and sodium bicarbonate.
Is PEA The first monitored rhythm?
The first monitored rhythm is VF/pVT in approximately 20% of cardiac arrests, both in-hospital or out-of-hospital. VF/pVT will also occur at some stage during resuscitation in about 25% of cardiac arrests with an initial documented rhythm of asystole or PEA. Non-shockable rhythms—asystole and PEA.
Does AED shock PEA?
Nonshockable Rhythms
As such the AED will not advise shock for these rhythms. There are two types of nonshockable rhythms, pulseless electrical activity (PEA) and asystole. PEA looks like an organized cardiac rhythm.
What are the 5 lethal cardiac rhythms?
You will learn about Premature Ventricular Contractions, Ventricular Tachycardia, Ventricular Fibrillation, Pulseless Electrical Activity, Agonal Rhythms, and Asystole. You will learn how to detect the warning signs of these rhythms, how to quickly interpret the rhythm, and to prioritize your nursing interventions.
Is ventricular fibrillation a form of PEA?
Ventricular fibrillation, pulseless electrical activity (PEA) and sudden cardiac arrest.
How long can PEA last?
PEA patients survival to ROSC, 30-days and 1-year survival and neurological state described with CPC classification one year after resuscitation.
Which drug is considered first line treatment for asystole or PEA?
Atropine is inexpensive, easy to administer, and has few side effects and therefore can be considered for asystole or PEA. The recommended dose of atropine for cardiac arrest is 1 mg IV, which can be repeated every 3 to 5 minutes (maximum total of 3 doses or 3 mg) if asystole persists (Class Indeterminate).
