Pulseless electrical activity (PEA) is best characterized as a rhythm that:

Pulseless electrical activity (PEA) is best characterized as a rhythm that:

• A. Shows electrical activity on the monitor but no palpable pulse
• B. Is always associated with a rapidly improving pulse
• C. Is a shockable rhythm
• D. Always responds to defibrillation

Answer: (A)

Pulseless electrical activity means the heart’s electrical rhythm on the monitor is organized, but there is no palpable pulse and no effective pumping action. In other words, the electrical system looks like it should produce a heartbeat, yet the heart isn’t actually pumping blood. Because the issue is mechanical not electrical, defibrillation (a shock) is not indicated and won’t restore a pulse. Management focuses on high-quality CPR and rapid identification and treatment of reversible causes (the Hs and Ts), along with appropriate medications like epinephrine. PEA can arise from problems such as low blood volume, poor oxygenation, acidosis or electrolyte disturbances, hypothermia, toxins, tamponade, tension pneumothorax, or thrombosis, and it can deteriorate toward asystole if not addressed.

Pulseless electrical activity means the heart’s electrical rhythm on the monitor is organized, but there is no palpable pulse and no effective pumping action. In other words, the electrical system looks like it should produce a heartbeat, yet the heart isn’t actually pumping blood. Because the issue is mechanical not electrical, defibrillation (a shock) is not indicated and won’t restore a pulse. Management focuses on high-quality CPR and rapid identification and treatment of reversible causes (the Hs and Ts), along with appropriate medications like epinephrine. PEA can arise from problems such as low blood volume, poor oxygenation, acidosis or electrolyte disturbances, hypothermia, toxins, tamponade, tension pneumothorax, or thrombosis, and it can deteriorate toward asystole if not addressed.