![]() If another reversible cause has not been discovered or if the patient is known to be susceptible to hypoglycemia (e.g., brittle diabetes, past surreptitious use of insulin) then this potential cause of PEA should be considered. *Hypoglycemia is not officially one of the H’s and T’s for adults, but it still can be an important cause of PEA, especially in children. It’s a clinical condition in which a patient experiences unresponsiveness in conjunction with a pulse that cannot be felt even when applying sufficient electrical discharge. Surgical embolectomy or administration of fibrinolyticsĮCG will be abnormal based on the location of the infarction Share What Is PEA Arrest Pulseless electrical activity (PEA) is also known as electromechanical dissociation. PEA, formerly known as electromechanical dissociation, occurs in patients who have organized cardiac electrical activity without a palpable pulse. Rapid heart rate with narrow QRS complexes on the ECG Typically will be seen as a prolonged QT interval on the ECG may see neurological symptoms Rapid heart rate and narrow QRS complexes on the ECG Slow heart rate and narrow QRS complexes on the ECG difficulty breathing They are also the most easily reversible and should be at the top of any differential diagnosis. Hypovolemia and hypoxia are the two most common causes of PEA. PEA may include any pulseless waveform with the exception of VF, VT, or asystole (Figure 28). Typically preceded by exposure to a cold environment PEA is one of many waveforms by ECG (including sinus rhythm) without a detectable pulse. There may be a subtle movement away from baseline (drifting flat-line), but there is no perceptible cardiac electrical activity. Peaked T waves and wide QRS complex on the ECGĬonsider calcium chloride, sodium bicarbonate, and an insulin and glucose protocol Pulseless electrical activity (PEA) and asystole are related cardiac rhythms in that they are both life-threatening and unshockable cardiac rhythms. ![]() Hyperventilation consider sodium bicarbonate bolusįlat T waves and appearance of a U wave on the ECG 23 A 12-lead ECG is difficult to obtain during ongoing resuscitation but, if available, can provide clues to the presence of hyperkalemia (eg, peaked T waves, complete heart block, ventricular. Infusion of normal saline or Ringer’s lactateĪirway management and effective oxygenation Nursing Priorities: Follow the ABCs Potential Treatment: Once an IV is established, plan to administer a vasopressor such as epinephrine or. Rapid heart rate and narrow QRS on ECG other symptoms of low volume Pulseless electrical activity can present as any organized or partially organized rhythm on an electrocardiogram (ECG). While it is important to continue to deliver compressions, ventilation, and medications according to the algorithm, it is always best to treat underlying causes of PEA and related conditions as soon as possible.
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