What causes PEA arrest?
What causes PEA arrest?
PEA is always caused by a profound cardiovascular insult (eg, severe prolonged hypoxia or acidosis or extreme hypovolemia or flow-restricting pulmonary embolus). The initial insult weakens cardiac contraction, and this situation is exacerbated by worsening acidosis, hypoxia, and increasing vagal tone.
What does PEA mean medically?
Introduction. Pulseless electrical activity (PEA), also known as electromechanical dissociation, is a clinical condition characterized by unresponsiveness and impalpable pulse in the presence of sufficient electrical discharge.
What happens when you shock PEA?
Pseudo-PEA is a form of severe shock in which diminished coronary perfusion leads to decreased myocardial function, thus further propagating hypotension. The pathologic insult causing the pseudo-PEA impedes the cardiovascular system’s ability to provide circulation throughout the body.
Can you survive PEA?
PEA is associated with a better prognosis than asystole but worse than that of VF. The survival rates to hospital discharge are approximately 4–7%, 2% and 17–21%, respectively[1, 7–10]. Incidences for hospital discharge are estimated to be 3.6/100 000/year for VF patients and 2.2/100 000/year for all-rhythm OHCA[1].
How is PEA arrest treated?
Cardiopulmonary resuscitation (CPR) is the first treatment for PEA, while potential underlying causes are identified and treated. The medication epinephrine (aka adrenaline) may be administered. Survival is about 20%.
Is PEA arrest a ventricular arrhythmia?
Pulseless electrical activity (PEA) is defined as organized ECG activity, excluding ventricular tachycardia and fibrillation, without clinical evidence of a palpable pulse or myocardial contractions.
How is PEA diagnosed?
As a result, PEA is usually noticed when a person loses consciousness and stops breathing spontaneously. This is confirmed by examining the airway for obstruction, observing the chest for respiratory movement, and feeling the pulse (usually at the carotid artery) for a period of 10 seconds.
Can PEA be reversed?
Hypovolemia and hypoxia are the two most common causes of PEA. They are also the most easily reversible and should be at the top of any differential diagnosis. If the individual has a return of spontaneous circulation (ROSC), proceed to post-cardiac arrest care.
Should you defibrillate 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.
What drug do you give for PEA?
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.