ACLS review: Pulseless Electrical Activity- part 6

Assess Reversible Causes: 5Hs & 5Ts

·         Hypoxia

·         Hypovolemia

·         Hyper/hypokalemia

·         Hydrogen ions (acidosis)

·         Hypothermia

Assess Reversible Causes: 5Hs & 5Ts

·         Tension pneumothorax

·         Thrombosis: cardiac

·         Thrombosis: lungs

·         Tables/toxins

·         Tamponade, cardiac

Hypoxia

·         Hypoventilation and hypoxia are frequent causes of PEA

·         Assess ABCs

·         Give supplemental oxygen

·         Consider advanced airway management

·         Mechanical Ventilation

Hypovolemia

·         Look for tachycardia with narrow QRS complex

·         Assess and find bleeding sources

·         Fluid boluses with isotonic crystaloids

·         Volume expanders

·         Blood products

Hydrogen Ions (acidosis)

·         Assess ABGs

·         Bicarb 1mEq/kg

           Known pre-existing bicarbonate responsive acidosis
           Intubated patient with continued long arrest interval
           Upon return of spontaneous circulation after long arrest interval
           Tricyclic antidepressant or aspirin overdose
           Known prexisting hyperkalemia

· Treat respiratory acidosis with ventilation



Reviewed 2/28/16