ACLS review: Pulseless Electrical Activity- part 10

Thrombosis, Coronary

·         MONA

·         Follow ACS algorithm

Thrombosis, Pulmonary

·         Thrombolytics

·         Heparin infusion

·         Surgery

Search for Possible Causes

Rhythm

·         Wide QRS: suggests massive myocardial injury, hyperkalemia, hypoxia, hypothermia

·         Wide QRS+Slow: consider drug OD (tricyclics, beta-blockers, Ca-blockers, digoxin)

·         Narrow complex: suggests intact heart; consider hypovolemia, infection, PE, tamponade

Consider Termination of Efforts

The final decision to stop can never rest on a single parameter, such as duration of resuscitative efforts. Rather, clinical judgment and respect for human dignity must enter

into decision making. In the out-of-hospital setting, cessation of resuscitative efforts in adults should follow system specific criteria under direct medical control.

References

Aehlert, Barbara. ACLS Quick Review Study Guide, 2^nd edition.  Mosby, inc.  St. Louis, Mo. 1994.

Neumar RW, Otto CW, Link MS, Kronick SL, Shuster M, Callaway CW, Kudenchuk PJ, Ornato JP, McNally B, Silvers SM, Passman RS, White RD, Hess EP, Tang W, Davis D, Sinz E, Morrison LJ. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(suppl 3):S729–S767

Reviewed 2/28/16