Respiratory failure leading to hypoxia is one of the most common causes of pulseless electrical activity, responsible for about half of the PEA cases.
What are the causes of pulseless electrical activity?
PEA is always caused by a profound cardiovascular insult (eg, severe prolonged hypoxia or acidosis or extreme hypovolemia or flow-restricting pulmonary embolus). The initial insult weakens cardiac contraction, and this situation is exacerbated by worsening acidosis, hypoxia, and increasing vagal tone.
Can hyperkalemia cause PEA?
The causes of secondary PEA are often remembered using the 4 Hs and 4 Ts mnemonic: Hypovolemia, Hypoxia, Hypothermia, and Hypo- or Hyper-electrolytemia (hyperkalemia, hypocalcemia), Tension pneumothorax, pericardial Tamponade, Thromboembolism, and Toxins (anesthetic overdose).
What are the most common reversible causes of PEA?
What are the reversible causes of pulseless electrical activity (PEA)?
- Hypovolemia.
- Hypoxia.
- Acidosis.
- Hypokalemia/hyperkalemia.
- Hypoglycemia.
- Hypothermia.
- Toxins (eg, tricyclic antidepressants, digoxin, calcium channel blocker, beta-blockers)
- Cardiac tamponade.
What is the treatment for pulseless electrical activity?
Treatment / Management
The first step in managing pulseless electrical activity is to begin chest compressions according to the advanced cardiac life support (ACLS) protocol followed by administrating epinephrine every 3 to 5 minutes, while simultaneously looking for any reversible causes.
How do you identify pulseless electrical activity?
Pulseless electrical activity (PEA) refers to cardiac arrest in which the electrocardiogram shows a heart rhythm that should produce a pulse, but does not. Pulseless electrical activity is found initially in about 55% of people in cardiac arrest.
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| Pulseless electrical activity | |
|---|---|
| Specialty | Cardiology |
Do you shock pulseless electrical activity?
Rhythms that are not amenable to shock include pulseless electrical activity (PEA) and asystole. In these cases, identifying primary causation, performing good CPR, and administering epinephrine are the only tools you have to resuscitate the patient.
Can you survive PEA?
The overall prognosis for patients with pulseless electrical activity (PEA) is poor unless a rapidly reversible cause is identified and corrected. Evidence suggests that electrocardiographic (ECG) characteristics are related to the patient’s prognosis.
What is worse Hypo or hyperkalemia?
If left untreated, both severe hypokalemia and severe hyperkalemia can lead to paralysis, cardiac arrhythmias, and cardiac arrest. Hyperkalemia, generally carries a higher risk of morbidity and mortality if left untreated. Severe hypokalemia may also cause respiratory failure, constipation and ileus.
What are the signs of hyperkalemia?
What are the symptoms of hyperkalemia (high potassium)?
- Abdominal (belly) pain and diarrhea.
- Chest pain.
- Heart palpitations or arrhythmia (irregular, fast or fluttering heartbeat).
- Muscle weakness or numbness in limbs.
- Nausea and vomiting.