Epinephrine
should be administered in 1-mg doses intravenously/intraosseously (IV/IO) every 3-5 minutes during pulseless electrical activity (PEA) arrest. Higher doses of epinephrine have been studied and show no improvement in survival or neurologic outcomes in most patients.
What medication is used for pulseless electrical activity?
Inotropic, anticholinergic, and alkalinizing agents
are used in the treatment of pulseless electrical activity (PEA). As previously stated, resuscitative pharmacology includes epinephrine and atropine.
What drugs are used in PEA?
The mainstay of drug therapy for PEA is
epinephrine (adrenaline) 1 mg every 3–5 minutes
. Although previously the use of atropine was recommended in the treatment of PEA/asystole, this recommendation was withdrawn in 2010 by the American Heart Association due to lack of evidence for therapeutic benefit.
Which medications should be administered when treating a patient in pulseless electrical activity or asystole?
Atropine
is inexpensive, easy to administer, and has few side effects and therefore can be considered for asystole or PEA. The recommended dose of atropine for cardiac arrest is 1 mg IV, which can be repeated every 3 to 5 minutes (maximum total of 3 doses or 3 mg) if asystole persists (Class Indeterminate).
How is pulseless treated?
Medical treatment of pulseless VT usually is carried out along with defibrillation and includes
intravenous vasopressors and antiarrhythmic drugs
. 1 mg of epinephrine IV should be given every 3 to 5 minutes. Epinephrine can be replaced by vasopressin given 40 units IV once.
What can you do for pulseless electrical activity?
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.
What can cause pulseless electrical activity?
Various causes of pulseless electrical activity include significant
hypoxia
, profound acidosis, severe hypovolemia, tension pneumothorax, electrolyte imbalance, drug overdose, sepsis, large myocardial infarction, massive pulmonary embolism, cardiac tamponade, hypoglycemia, hypothermia, and trauma.
Do you defibrillate for PEA?
Ts. 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.
Which drug is given first to a patient with pulseless electrical activity PEA?
Epinephrine
should be administered in 1-mg doses intravenously/intraosseously (IV/IO) every 3-5 minutes during pulseless electrical activity (PEA) arrest.
Can you have a BP with PEA?
However, PEA is not always a cardiac arrest state. In many cases, patients with PEA
have underlying cardiac activity and detectable arterial blood pressure
.
What does pulseless electrical activity look like on ECG?
| PEA Regularity Any rhythm including a flat line (asystole). | P Wave Possible P wave or none detectable. |
|---|
What does pulseless electrical activity mean?
Pulseless electrical activity (PEA) is
a clinical condition characterized by unresponsiveness and the lack of a palpable pulse in the presence of organized cardiac electrical activity
. Pulseless electrical activity has previously been referred to as electromechanical dissociation (EMD). (See Etiology.)
Why is asystole not shockable?
Pulseless electrical activity and asystole or flatlining (3 and 4), in contrast, are non-shockable, so
they don’t respond to defibrillation
. These rhythms indicate that the heart muscle itself is dysfunctional; it has stopped listening to the orders to contract.
Why is pulseless VT shockable?
| CAUSES TREATMENT | Tension pneumothorax needle decompression with eventual chest tube | Thrombosis (myocardial infarction or pulmonary embolus) treat per cause |
|---|
Do you shock V fib?
Ventricular fibrillation is life-threatening and requires prompt treatment. Collapse and sudden cardiac death will follow in minutes unless medical help is provided immediately. If treated in time, ventricular fibrillation
can be converted into a normal rhythm by shocking the heart with a
device called a defibrillator.
What are the H and T of ACLS?
Important causes include the 5 H’s and 5 T’s:
Hypoxia
, Hypovolemia, Hydrogen ions (acidosis), Hyper/Hypo-kalemia, Hypothermia; Tension pneumothorax, Tamponade-cardiac, Toxins, Thrombosis-coronary (MI), Thrombosis-pulmonary (PE).
