Tag Archive for: PEA

How Do You FEEL About Echo in Cardiac Arrest?

13 Jul
July 13, 2018

Background: Focused use of ultrasound in resuscitation of patients with shock and cardiac arrest has become increasingly embraced in both the emergency department (ED) as well as in the prehospital setting. Application of ultrasound, particularly of echocardiography, has the potential to identify treatable causes of shock and arrest, identify shockable rhythms and identify the presence of mechanical activity. All of these can affect management decisions and, potentially effect outcomes. Recent studies have led to concerns that integration of point of care ultrasound (POCUS) in cardiac arrest increases pauses in compressions. Thus, it is important to establish what POCUS adds to shock and arrest management. Read more →

REBEL Cast Ep 54: What the Heck is Pseudo-PEA?

27 Jun
June 27, 2018

Background: Pulseless electrical activity (PEA) is an organized electrical activity without a palpable pulse.  1/3 of cardiac arrest cases will be pulseless electrical activity and the overall prognosis of these patients is worse than patients who have shockable rhythms (ventricular fibrillation or pulseless ventricular tachycardia).  It can be a challenge to decide when to terminate or continue resuscitation efforts in PEA arrest.  Palpating pulses is difficult in the setting of a code situation, neither sensitive nor specific based on current literature.  The use of POCUS could help split PEA patients into Pseudo-PEA (cardiac activity on US = profound shock) vs True-PEA (no cardiac activity on US) in determining the potential for ROSC. Read more →

Beyond ACLS: A New Pulseless Electrical Activity Algorithm

18 May
May 18, 2015

Pulseless Electrical ActivityPatients with pulseless electrical activity (PEA) account for almost 1/3 of cardiac arrest and even more troublesome is that the survival rate is significantly worse than patients with shockable rhythms. Both the European and American ACLS guidelines stress the importance of quickly finding and addressing the cause of PEA. This is traditionally done with recalling the 5 to 6 H’s and T’s, but during cardiopulmonary resuscitation it is difficult to recall all 13 causes of PEA by trying to recall this list. In 2014 a review article was published that was developed by several departments from the Carolinas Medical Center in Charlotte, NC that tried to simplify the diagnostic approach to PEA. Read more →