Pulseless electrical activity causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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
- 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.