Pulseless Electrical Activity (PEA) Rhythm

PEA rhythm occurs when any heart rhythm that is observed on the electrocardiogram
(ECG) does not produce a pulse. PEA can come in many different forms. Sinus Rhythm,
tachycardia, and bradycardia can all be seen with PEA.

Performing a pulse check after a rhythm/monitor check will ensure that you identify PEA
in every situation.

Pulseless electrical activity usually has an underlying treatable cause. The most
common cause inemergency situations is hypovolemia.
PEA is treated by assessing and correcting the underlying cause. These causes can be
summed up in the 6 Hs and 6 Ts of ACLS. Use the link to review the Hs and Ts.
When an underlying cause for pulseless electrical activity cannot be determined, PEA
should be treated in the same fashion as asystole
Pulseless electrical activity is treated using the right branch of the puslesless arrest
arrest algorithm. Click below to view the pulseless arrest algorithm diagram. When done
click again to close the diagram.
Pulseless Arrest Algorithm Diagram.
Pop-Quiz:
Question #1: If you saw the rhythm below after defibrillation, how would you determine if
it is pulseless electrical activity?

click here for answer (ANSWER-You should check for a carotid or femoral pulse)

Question #2: What is the most common cause of PEA?

click here for answer (ANSWER-Hypovolemia)