As a nurse you want to be familiar with different types of heart rhythms, especially life-threatening rhythms like Pulseless Electrical Activity (PEA).
Before reviewing these notes, don’t forget to check out the lecture on Pulseless Electrical Activity (PEA).
Pulseless Electrical Activity (PEA)
How to identify it?
This rhythm looks like an organized rhythm, but the patient will have NO pulse and be unresponsive. Therefore, the rhythm doesn’t match your patient.
The organized presentation of this rhythm can vary in that you may see something on the ECG that looks like normal sinus rhythm, sinus bradycardia, sinus tachycardia etc. In addition, you may or may NOT see p waves and QRS complex. However, again when you go to check the patient, they will have NO pulse and be unresponsive.
This rhythm is a great example of why you can’t always trust the ECG monitor and must check the patient for yourself.
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Causes of Pulseless Electrical Activity (PEA)
Hypovolemia (shock), hypoxia, electrolyte imbalance (example high or low potassium), thrombosis, some type of trauma, cardiac disease etc.
Treatment for Pulseless Electricial Activity (PEA)
When you confirm the patient is experiencing PEA, get help by activating emergency response system (call a code blue etc.) and start CPR. When help arrives follow ACLS algorithm recommendations.
This includes rhythm checks. It’s important to note that Pulseless Electrical Activity (PEA) is a non-shockable rhythm. Therefore, it can’t be defibrillated. Medications that can be administered are Epinephrine. Other treatment includes supporting the airway.
As the patient is resuscitated it’s important to think of a potential cause of the rhythm. Think of the H’s and T’s: hypovolemia, hypoxia, toxins, thrombosis and so forth.
Now test your knowledge with this Pulseless Electrical Activity (PEA) Quiz.
References:
American Heart Association | Algorithms. (n.d.). Retrieved September 2, 2022, from https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms#adult
Oliver TI, Sadiq U, Grossman SA. Pulseless Electrical Activity. [Updated 2022 May 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513349/