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– *** Atropine was recommended previouisly – this was withdrawn as of 2010 by the American Heart Association due to actual evidence of benefits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