Pulseless electrical activity
Pulseless electrical activity (PEA) is a critical condition that occurs during cardiac arrest, where a person exhibits no detectable pulse or blood pressure, yet heart monitors reveal electrical activity in the heart. This paradox is typically caused by two main factors: hypovolemia, which is a significant decrease in blood volume often due to injury or internal bleeding, and hypoxemia, characterized by insufficient oxygen levels in the bloodstream, potentially resulting from lung disease, heart issues, or certain medications.
Diagnosis of PEA involves recognizing key symptoms, including unconsciousness, a consistent rhythm on the heart monitor, and discolored skin indicating oxygen deprivation. Treatment primarily consists of cardiopulmonary resuscitation (CPR) rather than electrical shocks, as the heart's electrical systems may still be functioning correctly despite its lack of mechanical activity. If CPR is ineffective, medical professionals may administer epinephrine to stimulate heart function. Timely intervention is crucial, as prolonged PEA can lead to irreversible heart failure and increased mortality risk. Understanding PEA is essential for recognizing the importance of immediate medical response in cardiac emergencies.
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Pulseless electrical activity
Pulseless electrical activity (PEA) refers to cardiac arrest commonly caused by a lack of blood in the circulatory system or a drop in the oxygen levels of blood in the circulatory system. During PEA, patients display no pulse or blood pressure, but electric heart monitors still read a pulse. The condition is usually treated with CPR or injections of epinephrine. It is not treated with electrical stimulation.
Overview
Pulseless electrical activity (PEA) commonly occurs during cardiac arrest. During PEA, the attending medical professional will be unable to find a pulse in the patient. However, a heart monitor shows electrical activity within the heart. This condition is most commonly caused by hypovolemia and hypoxemia. Hypovolemia refers to a significant decrease of blood circulating through the body. If the patient has been badly injured, hypovolemia is likely the cause of PEA. However, if the patient is not visibly injured, bleeding may still be the cause of PEA. Internal bleeding is less immediately apparent but may still result in a significant loss of blood to the heart.
Hypoxemia refers to an unusually low amount of oxygen in the bloodstream. This can have numerous causes, including lung disease, heart problems, and anemia. Certain pain medications can also have complications that result in hypoxemia.
Medical professionals look for a few key symptoms when diagnosing PEA. First, the patient must be completely unconscious and usually undergoing some form of cardiac distress. Second, when a heart monitor is attached, it must show a consistent rhythm on the screen. However, when the patient is checked for a pulse, none can be found at any point on the patient’s body. The patient will also feel as if he or she has no blood pressure. Third, a patient experiencing PEA may have discolored skin. The skin may turn blue or gray from lack of oxygen.
PEA is usually treated with cardiopulmonary resuscitation (CPR). It is not initially treated with electrical shocks like cardiac arrest. Though the heart is not functioning properly, its electrical systems are working correctly. However, as the cardiovascular system reacts to CPR, the heart monitor may indicate that the patient has transitioned into asystole. If this is the case, the patient may then be treated with electrical shocks. If the patient fails to react to CPR, medical staff may administer an injection of epinephrine. If the patient continues to display PEA, another shot of epinephrine can be delivered in several minutes.
Rapidly treating PEA is important. The individual suffering from PEA may appear to be stable and otherwise display normal signs of life. However, unless normal heart function is restored, the electrical activity in the heart will fade over time. When this occurs, the patient is at risk of dying.
Bibliography
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