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Pulseless electrical activity (PEA) is a form of cardiac arrest in which the electrocardiogram shows a heart rhythm that should produce a pulse, but does not. Pulseless electrical activity is found initially in about 20% of out-of-hospital cardiac arrests [ 1 ] and about 50% of in-hospital cardiac arrests.
The two "shockable" rhythms are ventricular fibrillation and pulseless ventricular tachycardia, while the two "non-shockable" rhythms are asystole and pulseless electrical activity. [65] Moreover, in the post-resuscitation patient, a 12-lead EKG can help identify some causes of cardiac arrest, such as STEMI which may require specific treatments.
Defibrillation is effective only for certain heart rhythms, namely ventricular fibrillation or pulseless ventricular tachycardia, rather than asystole or pulseless electrical activity, which usually requires the treatment of underlying conditions to restore cardiac function. Early shock, when appropriate, is recommended.
Successful ACLS treatment starts with diagnosis of the correct EKG rhythm causing the arrest. Common cardiac arrest rhythms covered by ACLS guidelines include: ventricular tachycardia , ventricular fibrillation , Pulseless Electrical Activity , and asystole .
An example EKG for pulseless electrical activity. In this rhythm, cardiac activity will be seen on electrocardiogram, but a pulse will not be felt on provider's exam. An EKG showing asystole, or "flat-lining." Patients will present following a traumatic event most often with pulseless electrical activity (PEA). Patients will exhibit low blood ...
Defibrillation is indicated only in certain types of cardiac dysrhythmias, specifically ventricular fibrillation (VF) and pulseless ventricular tachycardia. [1] [2] If the heart has completely stopped, as in asystole or pulseless electrical activity (PEA), defibrillation is not indicated. Defibrillation is also not indicated if the patient is ...
Synchronized electrical cardioversion is used to treat hemodynamically unstable supraventricular (or narrow complex) tachycardias, including atrial fibrillation and atrial flutter. It is also used in the emergent treatment of wide complex tachycardias, including ventricular tachycardia, when a pulse is present.
Asystole (New Latin, from Greek privative a "not, without" + systolē "contraction" [1] [2]) is the absence of ventricular contractions in the context of a lethal heart arrhythmia (in contrast to an induced asystole on a cooled patient on a heart-lung machine and general anesthesia during surgery necessitating stopping the heart).