Pulseless Electrical Activity

Pulseless Electrical Activity (PEA) Rhythm

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, tachycardia, and 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 6 H’s and 6 T’s of ACLS. Use the link to review the H’s and T’s.

When an underlying cause for pulseless electrical activity cannot be determined, PEA should be treated in the same fashion as asystole

Pop-Quiz:

Question #1: If you saw the rhythm below after defibrillation, how would you determine if it is pulseless electrical activity?

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Question #2: What is the most common cause of PEA?
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