PEA or Pulseless Electrical Activity 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

Symptoms

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

Causes

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

H

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

T

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

Diagnosis

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

Treatment

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–  *** Atropine was recommended previouisly – this was withdrawn as of 2010 by the American Heart Association due to actual evidence of benefits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

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