PEA and it's ACLS algorithm | ACLS-Algorithms.com

Comments

  1. Joy says

    Hi,

    I have a doubt. In a scenario where there is a cardiac arrest and resuscitation in progress, the patient has been administered adrenaline at the beginning of this 2minute round after being defibrillated in the prev cycle as he was in VF. Now during the rhythm evaluation, you find him to be in PEA, would you then repeat a dose of adrenaline? (which would mean adrenaline in 2 consecutive rounds).

    • ACLS says

      Technically, you would want to wait at least three minutes after the first administration of Adrenaline to provide a second dose. Kind regards, Jeff

      • Paul Abate says

        Very true. EPI is given every 3-5 minutes while CPR is being performed regardless of the EKG rhythm.

    • ACLS says

      Ventricular standstill would be considered ventricular asystole. There would be p-waves being generated but the impulse is not being conducted to the ventricles. Kind regards, Jeff

  2. Do Van Minh says

    Hello,
    I have a question about role of sodium bicarbonate in cardiac arrest. Should we administration NaHCO3 during CPR.
    Thanks.

    • ACLS says

      Sodium bicarbonate is not included in any of the ACLS algorithms. Its use would be more conducive with the post cardiac arrest phase. All use within the cardiac arrest algorithms has long been discontinued because there was no data that showed the administration of sodium bicarbonate improved survival to hospital discharge. Kind regards, Jeff

    • ACLS says

      I think it would be a question of whether you had ETCO2 available. There are many hospitals where ETCO2 is not available in the setting where a cardiac arrest event occurs.
      As far as a general standard of care I would not say that healthcare has come to the place of determining that ETCO2 is the Standard of care over checking for a pulse during a cardiac arrest event.

      Kind regards,
      Jeff

  3. Kay says

    So for pea, the pulse and rhythm checks are not done every 2 minutes like in asystole? Or is it cpr for 5 rounds and then rhythm check every 2 minutes? Thanks

    • ACLS says

      A rhythm check is always performed every two minutes. When dealing with asystole you will only perform a pulse check if an organized rhythm is present. otherwise, there’s no need to check for a pulse if there is no organized rhythm.

      Kind regards,
      Jeff

  4. Kuburat Agyemang-Boakye says

    Hello,
    I need the treatment Algorithm for pulseless patient in code blue with a history of DVT and A-Fib

    • ACLS says

      You would use the cardiac arrest algorithm, and use the left branch if the patient has VF or pulseless VT. Use the right branch if the patient has PEA or asystole. When dealing whether cardiac arrest, the history of DVT and AFib will not change the algorithm used. The history will help guide your assessment of the H’s and T’s.
      Kind regards, Jeff

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