![]() In PEA, there is electrical activity but insufficient cardiac output to generate a pulse and supply blood to the organs, whether the heart itself is failing to contract or otherwise. Under normal circumstances, electrical activation of muscle cells precedes mechanical contraction of the heart (known as electromechanical coupling). Pulseless electrical activity is found initially in about 20% of out-of-hospital cardiac arrests and about 50% of in-hospital cardiac arrests. Pulseless electrical activity ( PEA) is a form of cardiac arrest in which the electrocardiogram shows a heart rhythm that should produce a pulse, but does not. In both pathways, all of the treatments are designed around two-minute periods of uninterrupted, high-quality CPR.Medical condition Pulseless electrical activityĪ drawing of what a rhythm strip showing PEA could look like The left side of the algorithm outlines treatment for a shockable rhythm, like VFib or pulseless V-tach, while the right side of the algorithm outlines treatment for non-shockable rhythms, like asystole or pulseless electrical activity (PEA). The cardiac arrest algorithm consists of two pathways. And while asystole is most commonly seen after extended, untreated, and sudden cardiac arrest, it can also be caused by reversible conditions, known as the H’s and T’s: Common Causes of Asystole – the H’s Because there is no myocardial, electrical, or mechanical activity, there is no pulse and no circulation of blood and oxygen.Īsystole is most commonly seen following a period of unconverted ventricular fibrillations or ventricular tachycardia. What is the cardiac interpretation based on the ECG readout above? Based on these questions and the findings from the ECG readout, it would appear that this patient is in asystole. There is no evidence of a QRS complex, making any other questions about QRS non-applicable. The last thing ACLS providers should look at to determine if the sinus rhythm is normal or not is the QRS complex, asking themselves these questions while they do: ![]()
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