Megacode PEA Part 1

Pulseless Electrical Activity

PEA

Displays a rhythm on the monitor

Lacks a palpable pulse

Patients with PEA have poor outcomes

Need to find underlying cause ASAP

No pulse = no perfusion

PEA

Patients who have PEA will not benefit from defibrillation attempts.

The focus of resuscitation is to perform high-quality CPR with minimal interruptions and

to identify reversible causes or complicating factors

3:17 PM  A 65 year old female with end stage renal disease was found to be unresponsive and have "gasping" respirations.    This was the initial rhythm.   A weak pulse was present.   Positive pressure ventilations were initiated. 

3:20 PM  Despite aggressive ventilations, her heart rate slows down and her pulse is no longer palpapable.  A code blue is called and CPR is initiated.  Notice that the P wave amplitude is much smaller and the QRS complex is beginning to widen.   This could be related to hypoxia.