Which statement best describes Pulseless Electrical Activity (PEA) on ECG?

Which statement best describes Pulseless Electrical Activity (PEA) on ECG?

• A. There is no discernible rhythm on the monitor.
• B. The QRS complexes are similar in appearance and there may be a narrow or wide complex; the rate may be fast or slow, and the monitor shows an identifiable rhythm but no pulse.
• C. The QRS complexes are wide with irregular rhythm and a fast rate.
• D. P waves always precede the QRS complexes.

Answer: (B)

Pulseless Electrical Activity is when the heart’s electrical system shows activity on the monitor, producing an identifiable rhythm with QRS complexes that may be narrow or wide, but there is no palpable pulse or effective mechanical contraction. In practice, this means you see organized electrical signals on the ECG, yet the heart isn’t delivering enough output to generate circulation. That’s exactly what the option describes: an identifiable rhythm on the monitor with QRS complexes that can be similar in appearance and with a rate that can vary, but no pulse. The other scenarios don’t fit PEA: no discernible rhythm on the monitor describes asystole, a wide irregular fast rhythm fits a shockable rhythm like pulseless VT/VF, and P waves preceding QRS implies normal conduction with a pulse rather than PEA. In managing PEA, focus is on high-quality CPR and identifying reversible causes while administering appropriate pharmacologic support.

Pulseless Electrical Activity is when the heart’s electrical system shows activity on the monitor, producing an identifiable rhythm with QRS complexes that may be narrow or wide, but there is no palpable pulse or effective mechanical contraction. In practice, this means you see organized electrical signals on the ECG, yet the heart isn’t delivering enough output to generate circulation. That’s exactly what the option describes: an identifiable rhythm on the monitor with QRS complexes that can be similar in appearance and with a rate that can vary, but no pulse. The other scenarios don’t fit PEA: no discernible rhythm on the monitor describes asystole, a wide irregular fast rhythm fits a shockable rhythm like pulseless VT/VF, and P waves preceding QRS implies normal conduction with a pulse rather than PEA. In managing PEA, focus is on high-quality CPR and identifying reversible causes while administering appropriate pharmacologic support.