PEA is a “nonshockable” heart rhythm, meaning a defibrillator won't correct it. If not treated quickly, PEA causes sudden cardiac death within minutes.
The two are related cardiac rhythms, since they are both potentially deadly and non-shockable rhythms, requiring intervention before you can shock. An Asystole is a flat line ECG, so you may have subtle movement away from the baseline (a drifting flatline). But you cannot perceive the cardiac electrical activity.
Pulseless VT is a medical emergency that requires immediate defibrillation. The energy of 150-200 J on biphasic and 360 J on monophasic defibrillator should be used. Delaying defibrillation of pulseless VT dramatically decreases the survival rate.
Asystole is a non-shockable rhythm. Therefore, if asystole is noted on the cardiac monitor, no attempt at defibrillation should be made. High-quality CPR should be continued with minimal (less than five seconds) interruption.
Asystole isn't a shockable rhythm, and defibrillation may actually make it harder to restart the heart. Defibrillation is only an option if your heart goes from asystole to a shockable rhythm, which is possible when someone with asystole receives effective CPR.
PEA is a “nonshockable” heart rhythm, meaning a defibrillator won't correct it. If not treated quickly, PEA causes sudden cardiac death within minutes.
Know the Difference Between PEA and Asystole
Asystole is the flatline reading where all electrical activity within the heart ceases. PEA, on the other hand, may include randomized, fibrillation-like activity, but it does not rise to the level of actual fibrillation.
Rhythms that are not amenable to shock include pulseless electrical activity (PEA) and asystole.
The two nonshockable rhythms are pulseless electrical activity (PEA) and asystole and the two shockable rhythms are pulseless ventricular tachycardia and ventricular fibrilation.
VF and pulseless VT are both shockable rhythms. The AED cannot tell if the individual has a pulse or not.
Rhythms that are not amenable to shock include pulseless electrical activity (PEA) and asystole. In these cases, identifying primary causation, performing good CPR, and administering epinephrine are the only tools you have to resuscitate the patient.
AEDs have also demonstrated similar accuracy in correctly detecting non-shockable rhythms such as PEA, normal sinus rhythm, supraventricular arrhythmias and asystole.
If you use a public defibrillator on a person, it will do nothing. The defibrillator will sense that there is a heart rhythm and will not charge or shock a conscious person.
PEA is one of many waveforms by ECG (including sinus rhythm) without a detectable pulse. PEA may include any pulseless waveform with the exception of VF, VT, or asystole (Figure 28). Hypovolemia and hypoxia are the two most common causes of PEA.
Asystole Treatment Steps
Continue high-quality CPR for two minutes, while also attempting to establish IV or IO access. Give 1mg of epinephrine as soon as possible and every 3 to 5 minutes. After two minutes of CPR, check the patient's rhythm.
However, PEA is not always a cardiac arrest state. In many cases, patients with PEA have underlying cardiac activity and detectable arterial blood pressure.
You will need to be able to recognize the four lethal rhythms. Asystole, Ventricle Tachycardia (VT), Ventricle Fibrillation (VF), and Polymorphic Ventricle Tachycardia (Torsade de pointes).
When adrenaline is used, it should be used as soon as possible when the cardiac arrest rhythm is non-shockable, and after 3 defibrillation attempts for a shockable cardiac arrest rhythm.
An AED can only be used on someone with a rapid heart rate. You cannot use it on victims with an extremely slow heart rhythm or those whose heart stops beating. When the user puts the pads or electrodes on the victim's chest, the AED determines whether the victim's heart needs an electric shock or not.
Non-fatal arrhythmias
Supraventricular tachycardia is characterized by episodes in which your heart beats faster than expected. These episodes are often short and may cause no other symptoms. In these cases, no treatment may be necessary.
Therefore, a "No Shock Advised" message doesn't necessarily mean that the heart rhythm is back to normal; instead, it may mean that the victim is experiencing asystole or pulseless electrical activity; neither of which are treatable by shock.
The advanced cardiac life support (ACLS) 2010 guidelines allow vasopressin 40 IU IV as a 1-time dose treatment option in VF and asystole. This treatment can be given either before epinephrine or after the first dose of epinephrine.
Signs and Symptoms
A patient with PEA will be unconscious with no breathing and no pulse. PEA leads to a loss of cardiac output and discontinues blood supply to the brain. The skin may appear pallor due to no oxygen in the blood. Make sure to check for a pulse at the carotid artery.
This is when you have electricity in your heart, but it doesn't pump normally. It can turn into asystole if not treated right away. Other conditions that may lead to asystole include: Hypoxia: Low oxygen.
Asystole is the most serious form of cardiac arrest and is usually irreversible. Also referred to as cardiac flatline, asystole is the state of total cessation of electrical activity from the heart, which means no tissue contraction from the heart muscle and therefore no blood flow to the rest of the body.