The electrocardiogram (ECG) interpretation displays heart rhythm activity with similarities to a normal sinus rhythm, but the patient has no palpable pulse. In PEA, the heart’s electrical activity is present, but the heart muscle is not responding to the electrical impulses.
How do you identify a pulseless electrical activity on an ECG?
Pseudo-PEA can be detected in the absence of a palpable pulse by:
- arterial line placement during cardiac arrest (identified by the presence of a blood pressure)
- high ETCO2 readings in intubated patients.
- echocardiography or Doppler ultrasound demonstrating cardiac pulsatility.
Does pulseless electrical activity have heart rate?
Pulseless electrical activity frequently manifests as a very slow QRS complex with heart rates less than 40 beats per minute. Treatment includes emergency initiation of Advanced Cardiac Life Support (ACLS) protocols, which include treatment aimed at the etiology, if identifiable.
What rhythm has no pulse?
All cardiac arrest rhythms—that is, pulseless rhythms—that fall outside the category of pulseless ventricular tachycardia, ventricular fibrillation, or asystole are considered pulseless electrical activity.
What does asystole look like on an ECG?
Asystole is a condition of no electrical activity in the heart. It is seen on an EKG as a flatline. Cardiac contractions have stopped and no blood is flowing.
What is pulseless activity?
Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and the lack of a palpable pulse in the presence of organized cardiac electrical activity. Pulseless electrical activity has previously been referred to as electromechanical dissociation (EMD).
Is PEA a shockable rhythm?
Rhythms that are not amenable to shock include pulseless electrical activity (PEA) and asystole. In these cases, identifying primary causation, performing good CPR, and administering epinephrine are the only tools you have to resuscitate the patient.
What is PEA on EKG?
Pulseless electrical activity (PEA) occurs when a major cardiovascular, respiratory, or metabolic derangement results in the inability of cardiac muscle to generate sufficient force in response to electrical depolarization.
What does sinus tachycardia look like on ECG?
Sinus tachycardia is recognized on an ECG with a normal upright P wave in lead II preceding every QRS complex. This indicates that the pacemaker is coming from the sinus node and not elsewhere in the atria, with an atrial rate of greater than 100 beats per minute.
How can you tell if rhythm is shockable?
A shockable rhythm was defined as disorganized rhythm with an amplitude > 0.1 mV or, if organized, at a rate of > or = 180 beats/min. Wavelet-based transformation and shape-based morphology detection were used for rhythm classification.
What causes pulseless electrical activity?
Various causes of pulseless electrical activity include significant hypoxia, profound acidosis, severe hypovolemia, tension pneumothorax, electrolyte imbalance, drug overdose, sepsis, large myocardial infarction, massive pulmonary embolism, cardiac tamponade, hypoglycemia, hypothermia, and trauma.
What is shockable rhythm?
Shockable rhythms are heart rhythms that are caused by an aberration in the heart’s electrical conduction system. One important aspect of ACLS (advanced cardiac life support) is determining the right medication or therapy to use at the appropriate time and this includes deciding when to defibrillate.
What is pulseless VT?
Introduction. Pulseless ventricular tachycardia is a life-threatening cardiac arrhythmia in which coordinated ventricular contractions are replaced by very rapid but ineffective contractions, leading to insufficient organ perfusion and heart failure. Pulseless ventricular tachycardia is a medical emergency.
Why is asystole not a shockable rhythm?
Pulseless electrical activity and asystole or flatlining (3 and 4), in contrast, are non-shockable, so they don’t respond to defibrillation. These rhythms indicate that the heart muscle itself is dysfunctional; it has stopped listening to the orders to contract.
Is asystole a shockable rhythm?
Asystole is a non-shockable rhythm. Therefore, if asystole is noted on the cardiac monitor, no attempt at defibrillation should be made.
How is asystole and PEA treated?
ACLS Cardiac Arrest PEA and Asystole Algorithm
- Perform the initial assessment. …
- If the patient is in asystole or PEA, this is NOT a shockable rhythm.
- Continue high-quality CPR for 2 minutes (while others are attempting to establish IV or IO access)
- Give epinephrine 1 mg as soon as possible and every 3-5 minutes.