PEA may be seen immediately after defibrillation of which condition?

PEA may be seen immediately after defibrillation of which condition?

• A. Ventricular fibrillation or pulseless ventricular tachycardia
• B. Atrial fibrillation with rapid ventricular response
• C. Normal sinus rhythm
• D. Atrial flutter with a pulse

Answer: (A)

PEA is when electrical activity is seen on the monitor but there is no palpable pulse. After you defibrillate a shockable rhythm like ventricular fibrillation or pulseless ventricular tachycardia, the chaotic electrical activity can be interrupted and appear more organized, but the heart may not yet be pumping effectively. The myocardium can be temporarily stunned or ischemic, so there’s a brief window where you have an organized rhythm without a pulse—PEA. In this moment, continue high-quality CPR, give vasopressors, and pursue reversible causes while watching for return of spontaneous circulation. The other situations involve rhythms that either aren’t treated with defibrillation or already have a pulse, so they don’t describe PEA after defibrillation.

PEA is when electrical activity is seen on the monitor but there is no palpable pulse. After you defibrillate a shockable rhythm like ventricular fibrillation or pulseless ventricular tachycardia, the chaotic electrical activity can be interrupted and appear more organized, but the heart may not yet be pumping effectively. The myocardium can be temporarily stunned or ischemic, so there’s a brief window where you have an organized rhythm without a pulse—PEA. In this moment, continue high-quality CPR, give vasopressors, and pursue reversible causes while watching for return of spontaneous circulation. The other situations involve rhythms that either aren’t treated with defibrillation or already have a pulse, so they don’t describe PEA after defibrillation.