Pulseless electrical activity (PEA)

What is pulseless electrical activity?

• There is electrical activity in the heart, but there is no mechanical pumping activity. (Cardiac arrest)
• In ECG it can misleadinly seem that the heart is functioning normally and that's why it's hard to find out.
• Can be find out if arterial pressure is zero or rythm can not be found when feeling carotid artery.
• Prognosis is not good.

Reasons behind pulseless electrical activity

• Is not result from heart problems. 
• Normal reasons for PEA: pulmonary embolism, non-traumatic bleeding, difficult hypovolemia, pressure pneumotorax, cardiac tamponade, drug intoxication and hypothermia.

Treatment of pulseless electrical activity

• Cardio pulmonary resuscitation for two minutes.
•   At the same time cardio pulmonary resuscitation or as soon as possible adrenalin 1 mg i.v.
• Analyzing the ryhtm, if no changes cardio pulmonary resuscitation should be continued  
• Cardio pulmonary resuscitation is continued in two minute periods
• Adrenalin 1 mg i.v. is given 3-5 minute intervals, between two minute periods of cardio pulmonary resuscitation. 
• No defibrillitaion 

Reference: Kaisu Ikola, 2010. Teho- ja valvontahoitotyön opas. Ei defibrilloitavan rytmin tunnistus ja hoito. Duodecim. Akuuttihoidon tietokannat. Referred 19.02.2013 http://www.terveysportti.fi.ezproxy.jamk.fi:2048/dtk/aho/koti?p_artikkeli=tht00085&p_haku=syd%C3%A4men%20sykkeet%C3%B6n%20rytmi