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With PEA, electrical activity is present on the ECG but mechanical activity of the ventricles is not present.
1. Pulseless: patient has no viable pulse
2. Apneic: suspension of breathing/absence of respirations
3. Electrical activity on ECG: Even though electrical activity can be observed; no mechanical actvity of ventricles is evident
4. No heart tones on ascultation: becase of no cardiac electrical activity, contractions of the myocardium and no cardiac output or blood flow
5. Unresponsive: patient is unreactive, unresponse, apathetic and emotionless
Once PEA is suspected:
The biggest risk of PEA is death. Revealed in a recent study, only 11.2% of patients who had PEA as their first documented rhythm survived to hospital discharge.
Complications can arise from any of the aggressive life saving procedures done for PEA
Vasopressin-pituitary hormone
Promotes reabsorption of water via action on the renal tubular epithelium, causes vasoconstriction
Given subq, IM, IO, and IV
May replace either first or second dose of epinephrine
Epinephrine- bronchodilator nonselective adrenergic agonist, vasopressor
Causes bronchodilation, cardiac and CNS stimulation
Give subq, IM, intraosseously (IO) and IV
Epinephrine should be given in 1mg doses IV/IO every 3-5 min during PEA arrest
Atropine-antidysrhythmic, anticholinergic, parasympatholytic, antimuscarinic
Blocks acetylcholine at parasympathetic neuroeffector sites; increases cardiac output, HR by blocking vagal stimulaton in the heart
Give Subq, IM, PO, and IV
Administer if underlying cause of PEA is hypotension
It means exactly as it sounds, electrical activity without a palpable pulse.