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Med Princ Pract. 2014;23(1):1-6. doi: 10.1159/000354195. Epub 2013 Aug 13.

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

Author information

1
Department of Internal Medicine, Carolinas Medical Center, Charlotte, N.C., USA.

Abstract

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.

PMID:
23949188
PMCID:
PMC5586830
DOI:
10.1159/000354195
[Indexed for MEDLINE]
Free PMC Article

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