ACLS Test Prep: 5 Things You Need to Know About PEA

Pulseless electrical activity (PEA) is a form of cardiac arrest characterized by an ECG that shows a heart rhythm that should generate a pulse, but does not. Approximately, 55 percent of patients in cardiac arrest present with PEA–making it an important condition to understand if you are preparing for an upcoming ACLS certification exam. Here are 5 facts you should keep in mind when it comes to identifying and treating PEA.

1. PEA can only be differentiated from other forms of cardiac arrest when ECG/EKG monitoring is available.

2. High-quality CPR is the first line of treatment for PEA. While CPR is being administered, another member of the emergency response team should try to identify and treat the underlying cause.

3. The recommended drug therapy for PEA is 1 mg of epinephrine administered by IV every 3 to 5 minutes.

4. Although the following list is not exhaustive, common underlying causes of PEA include what is commonly referred to as the Hs and Ts:

  • Hypoxia

  • Hypovolemia

  • Hydrogen ion (acidosis)

  • Hyperkalemia

  • Hypothermia

  • Heart block

  • Cardiac Tamponade

  • Tension pneumothorax

  • Thrombosis

  • Tachycardia

  • Tablets or Toxins (drug overdose)

  • Trauma

5. Unless an underlying, treatable cause exists, there are essentially no survivors.

For more information on PEA and to review the ACLS PEA algorithm, check the ACLS Provider Manual. You can purchase the manual here or receive it as part of your tuition when you register for ACLS certification.