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What is PEA

PEA is the abbreviation for a type of cardiac arrest known as pulseless electrical activity. PEA is an organized rhythm without a pulse where the electrical activity of the heart may appear normal, but the heart muscle is not responding.

Signs and Symptoms of PEA

With PEA, the heart muscle is completely disassociated from the electrical activity. Any rhythm can deteriorate into PEA, so the patient’s pulse, blood pressure, and underlying conditions should all be closely monitored.  Performing high quality CPR is the initial treatment for PEA. In addition, identifying underlying causes like the H’s and T’s early and treating them quickly is the key to reversing most PEAs.

Some of the more common reversible causes of PEA can be remembered with the “H’s and T’s”:

PEA Treatment

Of the H’s and T’s, the most common potentially reversible causes of PEA are hypovolemia and hypoxia. In these cases, it is vital to recognize these conditions early and treat them quickly with volume replacement and oxygen therapy.

Pulseless electrical activity is not a shockable rhythm and treatment for PEA involves high quality CPR, airway management, IV or IO therapy, and appropriate medication therapy. The primary medication is 1 mg epinephrine 1:10,000 every 3-5 minutes rapid IV or IO push.

In order to correct pulseless electrical activity, the ultimate goal is to identify and treat the underlying cause of the cardiac arrest.