PEA rhythm occurs when any heart rhythm that is observed on the electrocardiogram (ECG) does not produce a pulse.
PEA can come in many different forms: Sinus Rhythm, Sinus tachycardia, and Sinus bradycardia can all be seen with PEA.
Performing a pulse check after a rhythm/monitor check will ensure that you identify PEA in every situation.
Pulseless electrical activity usually has an underlying treatable cause.
The most common cause in emergency situations is hypovolemia.
PEA is treated by assessing and correcting the underlying cause.
These causes can be summed up in the H’s and T’s.
The H’s include: The T's include:
Hypovolemia Toxins
Hypoxia Tamponade (cardiac)
Hydrogen ion (acidosis) Tension pneumothorax
Hyper-/hypokalemia Thrombosis (coronary / pulmonary)
Hypoglycemia Trauma
Hypothermia.
When an underlying cause for pulseless electrical activity cannot be determined, PEA should be treated in the same fashion as asystole.
Actions and Medications:
Atropine is no longer recommended for the treatment of PEA per the 2010 ACLS guidelines.
PEA can come in many different forms: Sinus Rhythm, Sinus tachycardia, and Sinus bradycardia can all be seen with PEA.
Performing a pulse check after a rhythm/monitor check will ensure that you identify PEA in every situation.
Pulseless electrical activity usually has an underlying treatable cause.
The most common cause in emergency situations is hypovolemia.
PEA is treated by assessing and correcting the underlying cause.
These causes can be summed up in the H’s and T’s.
The H’s include: The T's include:
Hypovolemia Toxins
Hypoxia Tamponade (cardiac)
Hydrogen ion (acidosis) Tension pneumothorax
Hyper-/hypokalemia Thrombosis (coronary / pulmonary)
Hypoglycemia Trauma
Hypothermia.
When an underlying cause for pulseless electrical activity cannot be determined, PEA should be treated in the same fashion as asystole.
Actions and Medications:
- Providing effective CPR
- Identification and correction of the cause of PEA
- Epinephrine
- Vasopressin
Atropine is no longer recommended for the treatment of PEA per the 2010 ACLS guidelines.