Pulseless electrical activity
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Pulseless Electrical Activity (PEA) (also known by the older term Electromechanical Dissociation or Non-Perfusing Rhythm) refers to any heart rhythm observed on the electrocardiogram that should be producing a pulse, but is not. The condition may or may not be caused by electromechanical dissociation. The most common cause is hypovolemia.
The normal condition when electrical activation of muscle cells precedes mechanical contraction is known as Electromechanical Coupling.
The goal of treatment of PEA is to treat the underlying cause. These possible causes are remembered as the Hs and Ts.[1][1][1]
- Hypovolemia
- Hypoxia
- Hydrogen ions (Acidosis)
- Hypothermia
- Hyperkalemia or Hypokalemia
- Hypoglycemia
- Tablets or Toxins (Drug overdose)
- Cardiac Tamponade
- Tension pneumothorax
- Thrombosis (Myocardial infarction)
- Thrombosis (Pulmonary embolism)
- Trauma (Hypovolemia from blood loss)
In those cases in which an underlying systemic cause is unable to be immediately identified, the patient should be treated as if they were in asystole: intravenous Epinephrine 1 mg every 3-5 minutes, and, if the underlying rhythm is bradycardia, Atropine 1 mg IV up to .04 mg/kg (varies with regional protocols). Both these drugs should be administered along with appropriate CPR techniques. Defibrillationis not used for this rhythm, as the problem lies in the response of the myocardial tissue to electrical impulses.
References
External links
- EMedicine: Pulseless Electrical Activity - EMedicine page on Pulseless Electrical Activity
de:Elektromechanische Entkoppelung
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
