Pulseless Electrical Activity
Cardiac arrest where the patient has cardiac electrical activity, which would
otherwise produce cardiac output and an obvious pulse. PEA usually has an
underlying treatable cause which, in emergency situations, is most often
hypovolemia. Performing a pulse check after a rhythm/monitor check will ensure
that PEA is identified.
Treatment (NOT shockable)...
After 2 minutes, recheck the patient's condition:
- Start CPR (30:2).
- Give Adrenaline 1mg, iv.
- Continue CPR 30:2 until airway secured, then continuously.
- Treat reversible causes of PEA.
- If a pulse is present, start post-resuscitation care.
- If rhythm is VF/VT, change to the shockable rhythm algorithm.
- If still in PEA, and no change in ECG appearance:
• Continue CPR.
• Give further adrenaline 1 mg every 3-5 min.