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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

Pulseless electrical activity is treated using the right branch of the puslesless arrest arrest algorithm. Click below to view the pulseless arrest algorithm diagram. When done click again to close the diagram.
Pulseless Arrest Algorithm Diagram.

Pop-Quiz:

Question #1: If you saw the rhythm below after defibrillation, how would you determine if it is pulseless electrical activity?
EKG of Sinus Rhythm with PVC's
click here for answer


Question #2: What is the most common cause of PEA?
click here for answer



You should check for a carotid or femoral pulse
Hypovolemia

  71 Responses to “Pulseless Electrical Activity”

  1. how does PEA tracing looks like

  2. Very helpful for renewal. I recommend putting it on your phone

  3. I might have missed this somewhere on the website, but what is the difference between performing a unsynchronized shock-defibrillation and a synchronized cardioversion? Is this just based on the rhythm identified on the monitor?
    Thanks!

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