JOURNAL ARTICLE
REVIEW

A simplified and structured teaching tool for the evaluation and management of pulseless electrical activity

Laszlo Littmann, Devin J Bustin, Michael W Haley
Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre 2014, 23 (1): 1-6
23949188
Cardiac arrest victims who present with pulseless electrical activity (PEA) usually have a grave prognosis. Several conditions, however, have cause-specific treatments which, if applied immediately, can lead to quick and sustained recovery. Current teaching focuses on recollection of numerous conditions that start with the letters H or T as potential causes of PEA. This teaching method is too complex, difficult to recall during resuscitation, and does not provide guidance to the most effective initial interventions. This review proposes a structured algorithm that is based on the differentiation of the PEA rhythm into narrow- or wide-complex subcategories, which simplifies the working differential and initial treatment approach. This, in conjunction with bedside ultrasound, can quickly point towards the most likely cause of PEA and thus guide resuscitation.

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