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Asystole or “flatline”
Asystole is not actually a true rhythm but rather is a state of no cardiac electrical activity. The main treatment of choice for asystole is the use of epinephrine and CPR.
Asystole is treated using the right branch of the Cardiac Arrest algorithm. Click below to view the Cardiac Arrest Algorithm diagram. When done click again to close the diagram.
Cardiac Arrest Algorithm Diagram.»
During asystole, there is no blood flow to the brain and other vital organs. This results in very poor outcomes if resuscitation is successful.
If asystole is visualized on the monitor, you should ensure that all leads are connected properly. If all leads are properly connected, you should rapidly assess for any underlying causes for the asystole.
As with pulseless electrical activity (PEA), asystole can have possible underlying causes which can be remembered using the H’s and T’s mnemonic.
In the following video, asystole is depicted on the defibrillator monitor and suggestions for treatment are given. Please allow several seconds for the video to load. (3.14 mb)
Question: What can sometimes be mistaken for asystole during a code?
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