Pulseless electrical activity causes: Difference between revisions
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|bgcolor="Beige"| [[Beta-blockers]], [[calcium channel blockers]], [[digitalis]], [[methylphenidate]]<ref name="pmid18957001">{{cite journal| author=Daly MW, Custer G, McLeay PD| title=Cardiac arrest with pulseless electrical activity associated with methylphenidate in an adolescent with a normal baseline echocardiogram. | journal=Pharmacotherapy | year= 2008 | volume= 28 | issue= 11 | pages= 1408-12 | pmid=18957001 | doi=10.1592/phco.28.11.1408 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18957001 }} </ref>, [[propofol | |bgcolor="Beige"| [[Beta-blockers]], [[calcium channel blockers]], [[digitalis]], [[methylphenidate]]<ref name="pmid18957001">{{cite journal| author=Daly MW, Custer G, McLeay PD| title=Cardiac arrest with pulseless electrical activity associated with methylphenidate in an adolescent with a normal baseline echocardiogram. | journal=Pharmacotherapy | year= 2008 | volume= 28 | issue= 11 | pages= 1408-12 | pmid=18957001 | doi=10.1592/phco.28.11.1408 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18957001 }} </ref>, [[propofol]], [[quinidine]], [[risperidone]]<ref name="pmid9220048">{{cite journal| author=Ravin DS, Levenson JW| title=Fatal cardiac event following initiation of risperidone therapy. | journal=Ann Pharmacother | year= 1997 | volume= 31 | issue= 7-8 | pages= 867-70 | pmid=9220048 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9220048 }} </ref> | ||
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Revision as of 20:58, 12 September 2013
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Resident Survival Guide |
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Pulseless electrical activity Microchapters |
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Differentiating Pulseless Electrical Activity from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Pulseless electrical activity causes On the Web |
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American Roentgen Ray Society Images of Pulseless electrical activity causes |
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Directions to Hospitals Treating Pulseless electrical activity |
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Risk calculators and risk factors for Pulseless electrical activity causes |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahmoud Sakr, M.D. [2]
Overview
Pulseless electrical activity is the initial presenting rhythm in 19.6% of patients who are monitored at the onset of cardiac arrest and 16.5% of patients who present to a prehospital system in full cardiac arrest. [1]
Causes
Life Threatening Causes
Pulseless electrical activity is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions can result in death or permanent disability within 24 hours if left untreated.
Common Causes
Common causes of PEA include preceding respiratory failure in 40% to 50% of cases, and hypovolemia. The common causes of PEA can be remembered using the mnemonic "The Hs and Ts".[2][3][4]
- Hypovolemia
- Hypoxia[5]
- Hydrogen ions (Acidosis)
- Hypothermia
- Hyperkalemia or Hypokalemia
- Hypoglycemia
- Tablets or Toxins (Drug overdose) such as beta blockers, tricyclic antidepressants, or calcium channel blockers
- Tamponade
- Tension pneumothorax
- Thrombosis (Myocardial infarction)
- Thrombosis (Pulmonary embolism)
- Trauma (Hypovolemia from blood loss)
As noted by repeated balloon inflations in the cardiac catheterization laboratory, transient occlusion of the coronary artery does not cause PEA.
Causes by Organ System
Causes in Alphabetical Order
References
- ↑ Stueven H, Troiano P, Thompson B, Mateer JR, Kastenson EH, Tonsfeldt D; et al. (1986). "Bystander/first responder CPR: ten years experience in a paramedic system". Ann Emerg Med. 15 (6): 707–10. PMID 3706861.
- ↑ ACLS: Principles and Practice. p. 71-87. Dallas: American Heart Association, 2003. ISBN 0-87493-341-2.
- ↑ ACLS for Experienced Providers. p. 3-5. Dallas: American Heart Association, 2003. ISBN 0-87493-424-9.
- ↑ "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - Part 7.2: Management of Cardiac Arrest." Circulation 2005; 112: IV-58 - IV-66.
- ↑ Sandberg WS (2005). "Endobronchial blocker dislodgement leading to pulseless electrical activity". Anesth Analg. 100 (6): 1728–30. doi:10.1213/01.ANE.0000149895.99151.20. PMID 15920204.
- ↑ 6.0 6.1 6.2 Hess EP, White RD (2004). "Out-of-hospital cardiac arrest in patients with cardiac amyloidosis: presenting rhythms, management and outcomes in four patients". Resuscitation. 60 (1): 105–11. doi:10.1016/j.resuscitation.2003.08.007. PMID 14987790.
- ↑ Virkkunen I, Paasio L, Ryynänen S, Vuori A, Sajantila A, Yli-Hankala A; et al. (2008). "Pulseless electrical activity and unsuccessful out-of-hospital resuscitation: what is the cause of death?". Resuscitation. 77 (2): 207–10. doi:10.1016/j.resuscitation.2007.12.006. PMID 18249482.
- ↑ 8.0 8.1 Daly MW, Custer G, McLeay PD (2008). "Cardiac arrest with pulseless electrical activity associated with methylphenidate in an adolescent with a normal baseline echocardiogram". Pharmacotherapy. 28 (11): 1408–12. doi:10.1592/phco.28.11.1408. PMID 18957001.
- ↑ 9.0 9.1 Ravin DS, Levenson JW (1997). "Fatal cardiac event following initiation of risperidone therapy". Ann Pharmacother. 31 (7–8): 867–70. PMID 9220048.
- ↑ 10.0 10.1 Fang AC, Carnell J, Stein JC (2012). "Constipation in a 7-year-old boy: congenital band causing a strangulated small bowel and pulseless electrical activity". J Emerg Med. 42 (3): 283–7. doi:10.1016/j.jemermed.2010.05.092. PMID 20832966.
- ↑ 11.0 11.1 Peppriell JE, Bacon DR (2000). "Acute abdominal compartment syndrome with pulseless electrical activity during colonoscopy with conscious sedation". J Clin Anesth. 12 (3): 216–9. PMID 10869921.
- ↑ 12.0 12.1 ten Cate FJ, Soliman OI, Michels M, Theuns DA, de Jong PL, Geleijnse ML, Serruys PW (2010). "Long-term outcome of alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy: a word of caution". Circulation. Heart Failure. 3 (3): 362–9. doi:10.1161/CIRCHEARTFAILURE.109.862359. PMID 20332420. Retrieved 2012-02-11. Unknown parameter
|month=ignored (help) - ↑ 13.0 13.1 Geddes LA, Roeder RA, Rundell AE, Otlewski MP, Kemeny AE, Lottes AE (2006). "The natural biochemical changes during ventricular fibrillation with cardiopulmonary resuscitation and the onset of postdefibrillation pulseless electrical activity". Am J Emerg Med. 24 (5): 577–81. doi:10.1016/j.ajem.2006.01.030. PMID 16938597.
- ↑ Stueven HA, Aufderheide T, Waite EM, Mateer JR (1989). "Electromechanical dissociation: six years prehospital experience". Resuscitation. 17 (2): 173–82. PMID 2546233.
- ↑ 15.0 15.1 Pant D, Vohra VK, Pandey SS, Sood J (2009). "Pulseless electrical activity during caesarean delivery under spinal anaesthesia: a case report of severe anaphylactic reaction to Syntocinon". Int J Obstet Anesth. 18 (1): 85–8. doi:10.1016/j.ijoa.2008.09.004. PMID 19111230.