What Is PEA (Pulseless Electrical Activity) And Why Is It Bad?
For students who are in ECG/EKG training, PEA (pulseless electrical activity) is a physical condition that causes no palpable pulse with unresponsiveness, while cardiac electrical activity is still organized and present, also known as electromechanical dissociation (EMD). If peripheral pulses are absent, this should not be evaluated with PEA, as this could be caused by severe disease of the peripheral vascular system. With pulseless electrical activity, the absence of heart contractions occur, while the coordinated electrical activity is still present.
During ECG/EKG classes, the student will learn that PEA is a serious condition that comprises the patient's life. This condition results from either respiratory, cardiovascular, or metabolic system breakdown, caused by a sudden change brought on by contractility, preload or afterload. The sudden stress on the heart will cause cardiac contractions to weaken, and as the condition becomes more exaggerated by the affects of hypoxia, acidosis and increased vagal tone, the heart muscles become unable to perform adequately, although electrical activity will still be present. Once the student receives ECG/EKG certification, they will understand that PEA is a serious condition that causes the heart rhythm to degenerate, and death to occur.
Causes of PEA are severe hypoxia (lack of oxygen), severe acidosis (excessive acid in the body fluids), severe hypovolemia (low blood volume) or pulmonary embolus. This condition is responsible for twenty percent of the deaths that occur outside of hospitals, sixty-eight percent of in-hospital monitored patients who die, and ten percent of over-all deaths within hospitals. This is believed to be caused due to the patient's serious condition when admitted, and the probability of having a pulmonary emboli or another condition that requires a ventilator, which can result in positive-end-expiratory pressure. When the first ECG/EKG was done upon patient's admittance into the hospital, the results showed PEA rhythm in thirty-two percent of adults who died inside of a hospital.
Patients who use medications such as beta-blockers, or calcium channel blockers, can have a higher risk of PEA, due to these type medications interfering with normal heart contractility. The mortality rate of patients who are admitted to hospitals with a positive PEA electrocardiogram rhythm is very high, with only eleven percent recovering and being discharged from the hospital. That is why this condition requires immediate attention upon the first reading of the ECG/EKG. Actions must be taken quickly to identify and reverse the cause if possible. For students who attend ECG/EKG classes, understanding this is extremely important since the ECG/EKG technician is usually the first one to take the recording and identify the abnormality associated with this condition. While ECG/EKG training, the student will come to understand this heart condition and how to recognized the PEA recorded results. For ECG/EKG certification, the student will be able to carry out the required actions quickly and effectively.
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