![]() A severe initial insult often reduces cardiac output which may in turn cause myocardial ischemia, left ventricular failure, hypoxia and metabolic acidosis. Any such event can lead to decrease in cardiac contractility, and the situation gets even worse by potential acidosis, hypoxia, and worsening vagal tone. PEA( pulseless electrical activity) usually occurs when an insult involves the cardiovascular, gastrointestinal or the respiratory systems. However there has been a change in approaching the causes of SCA, pointing to PEA as the initial rhythm leading to SCA. The explanation for this, is that ventricular fibrillation (VF) and ventricular tachycardia ( VT), were the main causes for the morbidity and mortality of SCA. Pulseless electrical activity as the main approach for sudden cardiac arrest ( SCA) was not completely studied until the middle of the 1980's. hypovolemic shock) which should be treated with IV fluidsor packed red blood cell transfusion. Immediately after administering epinephrine attention should be directed to reverse any possible causes of PEA as they are the most common causes like hypovolemia (i.e. The mainstay of drug therapy for PEA is epinephrine 1mg every 3–5 minutes. ![]() Administering 100% oxygen to reverse hypoxia, intubate the patient, establishing IV access should be the priority. According to the current American Heart Association- Advanced Cardiac Life Support (AHA-ACLS) guidelines CPR is the mainstay of treatment in all patients. Sometimes there is a bradycardia, with or without P waves, and often there is a wide QRS complex. ECG findings shows sinus rhythm or sinus tachycardia, with discernible P waves and QRS complexes. Echocardiogram can identify several rapidly reversible causes of PEA such as cardiac tamponade, myocardial infarction, cardiac rupture and underfilling of the ventricle due to hypovolemia. Absence of palpable pulse is the main finding. PEA is associated with a poor prognosis, particularly if the underlying cause is not readily identifiable and treated. ![]() The most common causes are respiratory failure and hypovolemia, Hypoxia, Hydrogen ions ( Acidosis), Hypothermia Hyperkalemiaor Hypokalemia, Hypoglycemia, Tablets or Toxins ( Drug overdose) such as beta blockers, tricyclic antidepressants, or calcium channel blockers, Tamponade, Tension pneumothorax, Thrombosis ( Myocardial infarction), Thrombosis ( Pulmonary embolism), Trauma ( Hypovolemia from blood loss), Covid-19. Pulseless electrical activity is defined as the absence of a pulse or cardiac contractility despite the presence of electrocardiographic activity. , Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S. Risk calculators and risk factors for Pulseless electrical activity overviewĮditor-In-Chief: C. Pulseless electrical activity overview in the newsīlogs on Pulseless electrical activity overviewĭirections to Hospitals Treating Pulseless electrical activity Pulseless electrical activity overview On the WebĪmerican Roentgen Ray Society Images of Pulseless electrical activity overviewĪll Images X-rays Echo & Ultrasound CT Images MRIįDA on Pulseless electrical activity overviewĬDC on Pulseless electrical activity overview Natural History, Complications and Prognosis Pulseless electrical activity Microchaptersĭifferentiating Pulseless Electrical Activity from other Diseases
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