Protocol 2-748 - Pulseless Electrical Activity

CMH EMS & MIH Protocols

EMD:

• No specific protocol.

EMR:

• Refer to Protocol 2-198 - Cardiac Arrest.
• If no pulse at pulse check and AED advises no shock advised. Continue Compressions.

EMT:

• Ensure completion of applicable items above.

AEMT:

• Ensure completion of applicable items above.

RN:

• Ensure completion of all applicable items above.
• Until proven otherwise, PEA should be considered and treated as PROFOUND SHOCK.
• Continue Compressions
• Consider and correct treatable causes: Hypovolemia, hypoxia, hypo/hyperkalemia, hypothermia, hypoglycemia, acidosis, tension pneumothorax, toxins, thrombosis, and cardiac tamponade.
• If abrupt jump in ETCO2 level during CPR great than 45. Expect Return of Spontaneous Circulation finding at next pulse check and refer to Post Resuscitation protocol for further treatments.

• Adult:	Pediatric:
  Slow PEA rate: Consider Atropine 1 mg IV/IO every 3-5 min (max 3 mg). Consider Pacing. Suspected mechanical cardiac activity: Consider large fluid bolus.

• Narrow complex PEA should NOT be terminated in the field.

Medic:

• Ensure completion of all applicable items above.

CP:

• Ensure completion of all applicable items above.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.