PEA and Asystole Overview for Medical Professionals

Questions and Answers

What are the 2 most common causes of Pulseless Electrical Activity? (Select all that apply)

Hypovolemia and hypoxia (correct)

Hypovolemia and hyperkalemia

Hypothermia and hypoxia

Hypoxia and hyperkalemia

What is the correct dosing regimen of epinephrine to treat PEA or Asystole?

300 mg bolus

1 mg IV/IO - repeated every 3 to 5 minutes (correct)

0.5 mg IV/IO - repeated every 8 to 10 minutes

1 mg IV/IO - repeated every 8 to 10 minutes

Pulseless Electrical Activity is defined as:

No electrical activity present on an ECG

A perfusing rhythm without spontaneous respirations

Ventricular Fibrillation

Any organized rhythm without a pulse (correct)

Possible causes of an isoelectric ECG (flat line) include:

All of the above Signup and view all the answers

Which of the following is not a reason to stop or withhold resuscitative efforts?

Resuscitation efforts have been unsuccessful for 20 minutes or more Signup and view all the answers

Routine insertion of an advanced airway in asystole:

Should only be performed if ventilations with a BVM are ineffective Signup and view all the answers

The first dose of amiodarone for PEA treatment is:

Amiodarone is not used in PEA Signup and view all the answers

Which of the following statements is not true?

Treatment of PEA is limited to interventions outlined in the algorithm Signup and view all the answers

Which of the following statements is true?

There is no evidence that attempting to 'defibrillate' asystole is beneficial Signup and view all the answers

PEA and Asystole are shockable rhythms.

False Signup and view all the answers

Study Notes

Pulseless Electrical Activity (PEA) and Asystole Overview

PEA is characterized by any organized rhythm without a pulse, displaying QRS complexes that are similar but may vary in rate and regularity.
Commonly reversible causes of PEA include hypovolemia and hypoxia.

Epinephrine Administration

The proper dosing regimen for epinephrine in PEA or asystole is 1 mg administered IV/IO, repeated every 3 to 5 minutes.

ECG Interpretation

An isoelectric ECG (flatline) might result from factors such as loose leads, lack of power to the monitor, or inadequate gain/amplitude settings.

Resuscitation Efforts

Rigor mortis and clear do-not-attempt-resuscitation (DNAR) status are valid reasons to stop resuscitative efforts.
Continuous efforts even after 20 minutes without success are grounded in clinical judgment, not strict time limits.

Advanced Airway Management

In asystole, advanced airway insertion should be considered only if bag-mask ventilation is insufficient, prioritizing ventilation effectiveness over IV/IO access.

Amiodarone Use in PEA

Amiodarone is not indicated for PEA; its use is reserved for ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT).

Treatment Protocols for PEA

Treatment of PEA extends beyond standard algorithm interventions; healthcare providers must actively seek and address underlying causes for successful resuscitation.

Defibrillation in Asystole

There is no evidence supporting the efficacy of defibrillation for asystole; attempts to shock are discouraged unless distinguishing between fine VF and asystole is necessary.

Rhythm Classification

PEA and asystole are classified as non-shockable rhythms, which guides treatment approaches and interventions.

Description

This quiz provides an overview of pulseless electrical activity (PEA) and asystole, focusing on recognition, management protocols including epinephrine dosing, and advanced airway considerations. It also covers essential ECG interpretation and resuscitation efforts. Test your knowledge on these critical life-saving concepts.