Pathophysiology Of Cardiovascular Disease Essay

953 words - 4 pages

PULSELESS ELECTRICAL ACTIVITY

Pulseless electrical activity refers to a cardiac arrest situation in which a heart rhythm is observed on the electrocardiogram that should be producing a pulse but is not. Under normal circumstances, electrical activation of the cardiac muscle cells precedes mechanical contraction of the heart. Pulseless electrical activity is also referred to as PEA or, by the older term, electromechanical dissociation. Pulseless electrical activity is the clinical condition characterized by unresponsive and lack of a palpable pulse in the presence of organized cardiac electrical activity. Electrical activity is a necessary but not sufficient condition for mechanical ...view middle of the document...

The main approach in treatment of pulseless electrical activity is to treat the underlying cause, if it is known. The treatment of pulseless electrical activity is similar to that of asystole in situation where an underlying cause cannot be determined and/or reversed. The mainstay of drug therapy for pulseless electrical activity is epinephrine 1mg every 3 to 5 minutes. Previously the use of atropine was recommended in the treatment of pulseless electrical activity/ asystole. This recommendation was withdrawn in 2010 by the American Heart Association due to the lack of evidence for therapeutic benefit. Sodium Bicarbonate 1mcq per kilogram may be considered in this rhythm as well, although there is little evidence to support this practice. Its routine use is not recommended for patients in this context, except in special situations. All of these drugs should be administered along with appropriate cardiopulmonary resuscitation techniques. Defibrillators are not used for this rhythm, as the problem lies in the response of the myocardial tissue to electrical impulses.
It is becoming increasingly common for emergency medical service providers to encounter patients with pulseless electrical activity. In the United States, it is currently estimated the pulseless electrical activity may occur in as many as thirty-five percent of prehospital cardiac arrests. Different form of pulseless electrical activity may be identified. Pulseless electrical activity may be referred to as primary pulseless electrical activity if identified as the first rhythm. In cases where pulseless electrical activity is defined as the rhythm after a patient has been defibrillated from ventricular fibrillation or ventricular tachycardia, it is referred to as post defibrillation pulseless electrical activity. This helps to clarify the type of pulseless electrical activity that is involved. It may potentially be used when trying to predict patient outcomes. If pulseless electrical activity is identified as the first rhythm that is managed in the prehospital environment, it is reported the patient will have a greater rate of restored spontaneous circulation. Knowing this may...

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