Everything about Pulseless Electrical Activity totally explained
Pulseless Electrical Activity (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 approach in treatment of PEA is to treat the underlying cause. These possible causes are remembered as the Hs and Ts.
Where an underlying systemic cause is unable to be determined in sufficient time, pulseless electrical activity should receive treatment methods as if the patient were in
asystole. Treatment is intravenous delivery
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.
Defibrillators are not used for this rhythm, as the problem lies in the response of the myocardial tissue to electrical impulses.
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