Pulseless Electrical Activity Management
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Questions and Answers

Why is defibrillation not indicated for Pulseless Electrical Activity (PEA) or Asystole?

  • There is no electrical activity to synchronize, rendering defibrillation ineffective. (correct)
  • The primary issue in PEA and Asystole is a rhythm disturbance that defibrillation cannot correct.
  • The heart muscle is already contracting forcefully; defibrillation would cause further damage.
  • Defibrillation can worsen the underlying cause of PEA and Asystole.

A patient in PEA is found to be hypovolemic. Besides epinephrine, what is the MOST appropriate intervention?

  • Prepare for transcutaneous pacing.
  • Administer a bolus of intravenous fluids. (correct)
  • Administer a vasopressor such as vasopressin.
  • Perform immediate pericardiocentesis.

During resuscitation of a patient in PEA, how frequently should epinephrine 1mg be administered?

  • Every 2 minutes
  • As a one-time dose only
  • Every 3-5 minutes or every other pulse check (correct)
  • Every 10-15 minutes

A patient is in PEA and IV access cannot be established. What is the next preferred route of medication administration?

<p>Intraosseous (C)</p> Signup and view all the answers

Why might CPR potentially induce ventricular tachycardia (VT) or ventricular fibrillation (VF) in a patient?

<p>CPR can cause direct trauma to the heart, leading to electrical instability. (A)</p> Signup and view all the answers

During resuscitation of a patient in PEA (Pulseless Electrical Activity), what key actions should be performed every two minutes?

<p>Checking rhythm, assessing for a pulse, alternating between airway management and chest compressions. (D)</p> Signup and view all the answers

After 20 minutes of CPR, what ETCO2 value suggests that efforts should be stopped?

<p>ETCO2 remaining at 10 mmHg or less (C)</p> Signup and view all the answers

In a patient experiencing cardiac arrest due to accidental hypothermia, what is the MOST appropriate intervention during rewarming?

<p>Administering vasopressors while rewarming the patient. (D)</p> Signup and view all the answers

Which characteristic is unique to Mobitz Type I (Wenckebach) second-degree AV block?

<p>Progressive lengthening of the PR interval until a QRS complex is dropped (D)</p> Signup and view all the answers

Mobitz Type II second-degree AV block is MOST accurately characterized by which of the following?

<p>A consistent PR interval with intermittent non-conducted P waves and dropped QRS complexes. (B)</p> Signup and view all the answers

Why is a third-degree AV block considered the most clinically significant type of AV block?

<p>It causes cardiovascular collapse and requires immediate pacing. (D)</p> Signup and view all the answers

A patient with a third-degree AV block has narrow QRS complexes on their ECG. This indicates:

<p>Third-degree AV block with junctional escape pacemaker (B)</p> Signup and view all the answers

When managing a patient with a third-degree AV block, why is pacing preferred over atropine?

<p>Pacing provides a reliable and immediate rhythm control, while atropine may be ineffective. (B)</p> Signup and view all the answers

Flashcards

What is PEA?

Pulseless Electrical Activity; there's electrical activity but no pulse.

PEA or Asystole: First Action?

Start CPR immediately to circulate blood and deliver oxygen.

PEA & Asystole: Primary Drug?

Epinephrine 1mg every 3-5 minutes, or every other pulse check.

What Defines PEA?

Organized rhythm on the monitor, but no palpable pulse.

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Possible PEA causes?

Hypovolemia, tension pneumothorax, cardiac tamponade, or PE.

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ETT (Every Two Minutes)

Ensures rhythm checks, pulse assessments, airway management, and chest compressions are performed every 2 minutes during resuscitation efforts

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Asystole

Absence of electrical activity on an ECG; also known as a 'flat line'

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Asystole Drug

Epinephrine 1mg every 3-5 minutes

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Accidental Hypothermia Treatment

External rewarming methods (bear hugger, warm blankets, warm IV fluids) and administer vasopressors

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Second Degree AV Block Mobitz Type 1 (Wenckebach)

PR interval gradually lengthens until a QRS complex is dropped; occurs at the AV node.

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Second Degree AV Block Mobitz Type 2

Consistent PR interval with randomly dropped QRS complexes; occurs below the AV node

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Third-Degree AV Block

Complete heart block requiring immediate pacing; may cause cardiovascular collapse. A pacemaker is necessary.

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Third-Degree AV Block HR

A rate of 40 is commonly associated with a complete AV block

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