Key Changes in Case 4 & 5 Pulseless Electrical Activity (PEA)/Asystole

PEA/Asystole is now included in the Algorithm for treatment of pulseless arrest

Pulseless Electrical Activity (PEA)/Asystole

  • BLS Algorithm: Call for Help
  • Give Oxygen when available
  • Attach monitor/defibrillator
  • Check Rhythm-If PEA/Asystole
  • CPR immediately for 5 cycles(2mins)
  • When IV/IO available, give vasopressor
  • Epinephrine 1 mg IV/IO May repeat 3 to 5 mins OR GIVE
  • May give 1 dose of vasopressin 40 units IV/IO to replace first or second dose of epinephrine
  • Consider Atropine 1 mg IV/IO for slow PEA Rate and Asystole Repeat every 3 to 5 min (up to 3 mg)
  • Give 5 cycles of CPR(2 mins)
  • Check Rhythm- Asystole/PEA
  • CPR 5 Cycles-(2 mins)
  • Search and Treat possible contributing Factors  6 Hs and 5 Ts
    • Hypovolemia
    • Hypoxia
    • Hydrogen Ion
    • Hypo/Hyper Kalemia
    • Hypothermia
    • Hypoglycemia (This is a new one added to the list)
    • Toxins
    • Tamponade, cardiac
    • Tension pneumothorax
    • Thrombosis (coronary or pulmonary)
    • Trauma
  • Pacing has failed to show benefit in Asystole, therefore you will no longer attempt to TRANSCUTANEOUS pace asystole.
  • The focus of resuscitation is to perform high-quality CPR with minimal interruptions and to identify reversible causes or complicating factors
  • DO NOT INTERRUPT CPR while establishing IV or IO access
  • Medications can be delivered simultaneously with CPR.