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PEA. Pulseless Electrical Activity. Definition. The heart muscle looses its ability to contract even though electrical activity is preserved. Also known as EMD - Electromechanical Dissociation or Non-Perfusing Rhythm. Symptoms. ECG shows organised electrical activity
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PEA Pulseless Electrical Activity Natalie Smith
Definition • The heart muscle looses its ability to contract even though electrical activity is preserved. • Also known as EMD - Electromechanical Dissociation or Non-Perfusing Rhythm
Symptoms • ECG shows organised electrical activity • Unable to palpate a pulse • Unable to measure blood pressure • Signs of progressive/irreversible stage of shock
Causes • Hypovolaemia • Hypoxia • Acidosis • Pneumothorax • Pulmonary Embolism • Hypothermia • Hyperkalemia
Hypovolaemia • During progressive stage of shock the heart becomes ischaemic and the capillaries become more permeable. • Fluid escapes into the tissues • Decreased blood flow to the heart causing arrhythmias leading to PEA
Treatment • Treat as if asystole • ALS - defib not used • Epinephrine (adrenaline) 1 in 10,000 - IV access, repeated every 3-5 mins • Atropine 3mg if in asystole…. 1mg if not • Treating causation - usually >50% blood volume if in PEA
References • Hand, H. (2001) Shock. Nursing Standard. 15, 48, 45-52 • Hubbard, J. (2003) Complications associated with myocardial infarction. Nursing Times. 99, 15 • Jackson, A. (2002) ECG Interpretation made incredibly easy. USA: Springhouse • Jevon, P. (2006) An overview of the new resuscitation guidelines. Nursing Times. 102, 03 • Verma, S. (2005) Pulseless Electrical Activity. [online]. Available from: <http://www.emedicine.com/med/topic2963.htm> [Accessed 9 July 2006].