Pulseless Electrical Activity also known as PEA is a heart condition where the heart rhythm can be observed on an EKG or electrocardiogram but there is an absence of a pulse.

Under normal conditions, the Heart is being activated by a group of muscle cells, that push the heart to contract.

In PEA, cardiac arrest occurs but there are no electrical activity.

Cardiopulmonary resuscitation or CPR is typically a treatment option until the underlining cause is treated or identified.

When there is no pulse and no rhythm – this is called Asystole


–  Cardiac Arrest
–  Loss of Consciousness
–  Stop Breathing
–  Lack of Pulse (Check for 10 seconds)


****Remember the 6 Hs and the 6 Ts


–  Hypovolemia
–  Hypoxia
–  Hydrogen ions  (Acidosis)
–  Hyperkalemia or Hypokalemia
–  Hypoglycemia
–  Hypothermia


–  Tablets or Toxins  (Drug overdose)
–  Tamponade (Cardiac Tamponade)
–  Tension pneumothorax
–  Thrombosis  (Mycardial Infarction)
–  Thrombosis  (Pulmonary Embolism)
–  Trauma  (Hypovolemia from blood loss)


–  An absence of a pulse while observing a rhythm on EKG/ECG.


1.)  Cardiopulmonary Resuscitation or CPR
2.)  Epinephrine – 1mg every 3-5 minutes

–  *** Atropine was recommended previouisly – this was withdrawn as of 2010 by the American Heart Association due to actual evidence of benefits

3.)  Sodium Bicarbonate 1 meq per kilogram

***  Ocassionaly used – but often seen in cases of preexisting metabolic acidosis, hyperkalemia, tricyclic antidepressants overdose, and other