Pulseless electrical activity PEA

• This condition is the presence of electrical activity normally associated with a cardiac output and the absence of a detectable pulse (see Chapters 8 and 11).

• Early identification and treatment will give the patient the best chance of survival (see later discussion). Continue resuscitation while identifying causes (Kloeck 1995).

• Follow the 'right loop' of the algorithm. CPR is started immediately and carried out for three minutes. Manage the airway and ventilation and initiate IV access. Epinephrine 1 mg is administered intravenously every three minutes. Atropine 3 mg IV may be given if the PEA is associated with bradycardia (<60/min) (Resuscitation Council UK 2000c).

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