Aufderheide TP, Thakur RK, Stueven HA, et al. 2009 Apr. : Cardiac arrest ultra-sound exam--a better approach to managing patients in primary non-arrhythmogenic cardiac arrest. 121:1-8. [Medline]. AHA Advanced Cardiovascular Life Support Provider … 2017 Oct. 64(10):2411-8. PEA is one of any number of ECG waveforms (even sinus rhythm) but without a detectable pulse. Factors associated with pulseless electric activity versus ventricular fibrillation: the Oregon sudden unexpected death study. Each case of PEA is unique and the rhythm seen on the monitor will therefore differ from case to case. Advanced Cardiac Life Support (ACLS) Certification Course, Ventricular Fibrillation and Pulseless Ventricular Tachycardia, Adult Immediate Post-Cardiac Arrest Care Algorithm. PEA, pulseless electrical activity is defined as any organized rhythm without a palpable pulse and is the most common rhythm present after defibrillation. ACLS Cardiac Arrest PEA and Asystole Algorithm Perform the initial assessment Perform high-quality CPR Establish an airway and provide oxygen to keep oxygen saturation > 94% Monitor the victim’s heart rhythm and blood pressure If the patient is in asystole or PEA, this is NOT a shockable rhythm Continue high … European Resuscitation Council guidelines for resuscitation 2015: Section 3. 17(2):183-93. Overall, OOHCA patients with PEA have poor outcomes (Andrew et al, 2014) survival to hospital discharge was 5.9% for PEA (compared with 1.1% for asystole) in survivors with 12-month follow-up data, the combined rate of death, vegetative state or lower severe disability was … list of "probable" or "reversible" causes, but does not give you a good way of either narrowing that list down or an order to rule things out • If the PEA is a narrow complex, look for obstructive causes first • If the PEA is a wide complex, look for metabolic causes first Circulation. Assess for ROSC and respond appropriately *If rhythm is shockable, … [Full Text]. [Medline]. They are also the most easily reversible and should be at the top of any differential diagnosis. Make sure pads make good contact with the individual, all cables are connected, the gain is set appropriately, and the power is on. Fuzaylov G, Woods B, Driscoll W. Documentation of resuscitation of an infant with pulseless electrical activity because of venous air embolism. An agonal rhythm is a waveform that is roughly similar to a normal waveform but occurs intermittently, … All material on this website is protected by copyright, Copyright © 1994-2021 by WebMD LLC. Once these basic measures are in place, reversible causes should be sought and corrected. The proposal of an integrated ultrasonographic approach into the ALS algorithm for cardiac arrest: the PEA protocol. [Medline]. 2017 Nov. 120:103-7. PROGNOSIS OF PEA. [Medline]. Thompson LE, Chan PS, Tang F, et al, for the American Heart Association’s Get With the Guidelines-Resuscitation Investigators. 2.) Resuscitation. Treatment of PEA is not limited to the interventions outlined in the algorithm. Hypovolemia and hypoxia are the two most common causes of PEA. 295(1):50-7. Simplifying the diagnosis and management of pulseless electrical activity in adults: a qualitative review. Desbiens NA. [Medline]. Be sure to look for evidence of these problems as you assess the patient. If the individual has a return of spontaneous circulation (ROSC), proceed to post-cardiac arrest care. 2017 Sep 22. These are (1) impairment of cardiac filling, (2) impaired pumping effectiveness of the heart, (3) circulatory obstruction and (4) pathological vasodilation causing loss of … [Medline]. [Medline]. Steven J Compton, MD, FACC, FACP Director of Cardiac Electrophysiology, Alaska Heart Institute, Providence and Alaska Regional Hospitals, Steven J Compton, MD, FACC, FACP is a member of the following medical societies: Alaska State Medical Association, American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, and Heart Rhythm Society, David S Marks, MD Director of Cardiac Catheterization Laboratory, Froedtert Memorial Lutheran Hospital; Associate Professor, Department of Internal Medicine, Section of Cardiology, Medical College of Wisconsin, David S Marks, MD is a member of the following medical societies: American College of Cardiology, American Heart Association, American Medical Association, Medical Association of Georgia, and Society for Cardiac Angiography and Interventions, Patrick O'Beirne, MD Fellow in Cardiovascular Medicine, University of Massachusetts Memorial Medical Center, Patrick O'Beirne, MD is a member of the following medical societies: American College of Cardiology, American Medical Association, Massachusetts Medical Society, and Phi Beta Kappa, Dionyssios A Robotis, MD, MPH, FACC Clinical Associate Professor of Medicine, University of Massachusetts Medical School; Consulting Staff Cardiologist/Electrophysiologist, University of Massachusetts Memorial Medical Center, Dionyssios A Robotis, MD, MPH, FACC is a member of the following medical societies: American College of Cardiology, Cardiac Electrophysiology Society, Heart Rhythm Society, and Massachusetts Medical Society, Lawrence Rosenthal, MD, PhD, FACC, FHRS Associate Professor of Medicine, Director, Section of Cardiac Pacing and Electrophysiology, Director of EP Fellowship Program, Division of Cardiovascular Disease, University of Massachusetts Memorial Medical Center, Lawrence Rosenthal, MD, PhD, FACC, FHRS is a member of the following medical societies: American College of Cardiology, American Heart Association, and Massachusetts Medical Society, Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference, Eric Vanderbush, MD, FACC Chief, Department of Internal Medicine, Division of Cardiology, Harlem Hospital Center; Clinical Assistant Professor of Cardiology, Columbia University College of Physicians and Surgeons, Eric Vanderbush, MD, FACC is a member of the following medical societies: American College of Cardiology and American Heart Association, Sumit Verma, MD, FACC Staff Electrophysiologist, Cardiology Consultants, Pensacola Heart Institute, Sumit Verma, MD, FACC is a member of the following medical societies: American College of Cardiology. 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