Pulseless Electrical Activity (PEA) Algorithm

Pulseless Electrical Activity (PEA) Algorithm

Pulseless Electrical Activity (PEA) Algorithm

Note: This document provides a structured summary of the Pulseless Electrical Activity (PEA) Algorithm for educational and reference purposes. It is not a substitute for certified ACLS training and adherence to the latest guidelines published by the American Heart Association (AHA) or other relevant governing bodies. Always consult the most current official guidelines.

1. Start CPR & Assess

Verify scene safety, check for responsiveness/breathing, activate EMS, get AED/defibrillator, begin high-quality CPR.

2. Assess Rhythm (PEA/Asystole)

Attach monitor/defibrillator. Confirm no pulse with any electrical activity (PEA) or no electrical activity (Asystole).

3. CPR 2 min & Access

Immediately resume high-quality CPR for 2 minutes. Gain IV/IO access.

4. Administer Epinephrine

Administer Epinephrine 1 mg IV/IO. Repeat every 3-5 minutes.

5. CPR 2 min & Assess Rhythm

Perform high-quality CPR for 2 minutes. Consider advanced airway/capnography. Assess rhythm and pulse (if organized) after 2 mins.

Rhythm Shockable?

Is the rhythm VF or pVT? Check for pulse if organized rhythm.

YES (Shockable)

Go to Shockable branch (VF/pVT) of the Cardiac Arrest Algorithm (Step 3).

NO (ROSC)

Go to Post-Cardiac Arrest Care.

NO (Non-Shockable)

Continue with PEA/Asystole management.

7. Identify and Treat Reversible Causes (H’s & T’s)

Hypoxia, Hypovolemia, Hypothermia, Hypo-/Hyperkalemia, Acidosis, Tamponade, Toxins, Tension pneumothorax, Thrombosis (coronary/pulmonary).

ROSC Achieved?

Check for pulse and signs of circulation.

YES (ROSC)

Go to Post-Cardiac Arrest Care.

NO (No ROSC)

Continue CPR. Consider terminating resuscitation based on guidelines and clinical judgment.

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