Administer high-quality CPR for 2 minutes. If shockable, move to VF/VT rhythm protocol. Administer epinephrine 0.01 mg/kg IV or 0.1 mg/kg per ETT every 3-5 minutes. As previously stated, resuscitative pharmacology includes epinephrine and atropine. An impalpable pulse should not always be taken as a pulseless electrical activity because it may be due to severe peripheral vascular abnormality.Ĭopyright © 2023, StatPearls Publishing LLC. Rhythm IS NOT shockable (asystole or pulseless electrical activity) 1. Inotropic, anticholinergic, and alkalinizing agents are used in the treatment of pulseless electrical activity (PEA). Pulseless electrical activity can include a number of organized cardiac rhythms that may be supraventricular in origin, sinus versus non sinus, or ventricular in origin such as accelerated idioventricular or escape. In these cases, identifying primary causation, performing good CPR, and administering epinephrine are the only tools you have to resuscitate the patient. Pulseless Electrical Activity (PEA) in Cardiac Arrest of Animals The ECG tracing can be normal or show an arrhythmia (commonly a bradyarrhythmia of ventricular or supraventricular origin), but the heart has no mechanical activity associated with the electrical activity: no contractions, no cardiac output, and subsequently, no pulses. True pulseless electrical activity is a state in which cardiac contractions are lacking in the presence of coordinated electrical impulses. Rhythms that are not amenable to shock include pulseless electrical activity (PEA) and asystole. There can be ventricular contractions and detectable pressures in the aorta, which are also known as pseudo-PEA. Treatment for a patient with congestive heart failure and shortness of breath may include: up to three doses of sublingual nitroglycerin. Pulseless electrical activity does not necessarily mean the lack of mechanical activity. The word “sufficient” is being used to describe a degree of ventricular mechanical activity that is adequate to generate a palpable pulse. Pulseless electrical activity has previously been referred to as electromechanical dissociation (EMD). In the case of cardiac arrest, the organized ventricular electrical activity does not usually follow sufficient ventricular response. Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and lack of palpable pulse in the presence of organized cardiac electrical activity. It means that the electrical activity is pertinent, but not sufficient, condition for contraction. A lack of ventricular impulse often points to the absence of ventricular contraction, but the contrary is not always true. Pulseless electrical activity (PEA), also known as electromechanical dissociation, is a clinical condition characterized by unresponsiveness and impalpable pulse in the presence of sufficient electrical discharge.
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