![]() For adult patients who have no pulse and an organized cardiac rhythm (indicative of pulseless electrical activity), the ACLS Cardiac Arrest Algorithm is utilized to guide treatment following the asystole/PEA pathway. In caring for an adult patient, the healthcare provider should initially complete the Basic Life Support (BLS) Assessment, the Advanced Cardiovascular Life Support (ACLS) Primary Assessment (such as managing the patient’s airway, providing supplemental oxygen if needed, evaluating their cardiac rhythm, monitoring vital signs, establishing intravenous (IV) or intraosseous (IO) access, evaluating H’s and T’s, etc.), and the ACLS Secondary Assessment (a focused medical history). Treatment of Pulseless Electrical Activity For example, patients who use beta-blockers or calcium channel blockers are at an increased risk for pulseless electrical activity as a result of decreased contractility of the heart due to altered intracellular calcium levels. Medications may increase susceptibility for the development of pulseless electrical activity. Hypoxia and hypovolemia are two of the most common and potentially reversible causes of pulseless electrical activity. Secondary pulseless electrical activity is due to potential reversible causes, also known as the Hs & Ts: Primary pulseless electrical activity is associated with cardiac causes (such as cardiac arrest), whereas secondary pulseless electrical activity is due to noncardiac causes. The risk for clinical mortality is increased in patients experiencing pulseless electrical activity.Ĭauses of pulseless electrical activity can be differentiated into primary and secondary causes. Further impairment of the contractility of the heart results, despite the presence of electrical activity within the heart, and mechanical activity of the heart becomes insufficient. This insufficient force results in a weakened ability of the heart to contract, which can lead to a worsening cascade of pathophysiological changes such as hypoxia, acidosis, and decreased vagal tone. Pulseless electrical activity occurs due to an event that takes place within the respiratory, cardiovascular, or gastrointestinal systems of the body which contributes to insufficient force generated by the heart following electrical depolarization. What Causes Pulseless Electrical Activity? ![]() When these rhythms present on a cardiac monitor they represent the respective rhythm and should be managed as such.
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