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Pulseless Electrical Activity

Aka: Pulseless Electrical Activity, Electromechanical Dissociation, Idioventricular Rhythm, Bradyasystolic Rhythm
  1. See Also
    1. Cardiopulmonary Resuscitation
    2. Ventricular Fibrillation
    3. Asystole
  2. Causes
    1. See Reversible Causes of Cardiopulmonary Arrest (5H5T)
  3. Management: Adults and children
    1. See Asystole (identical Epinephrine protocol)
      1. However empiric cause management differs from Asystole (see below)
      2. Atropine is no longer indicated for slow PEA (as of 2010)
    2. Assess blood flow
      1. Doppler ultrasound
      2. End-tidal CO2
      3. Echocardiography
      4. Arterial Line
    3. Consider causes as above and treat appropriately
      1. See Reversible Causes of Cardiopulmonary Arrest (5H5T)
      2. Fluid bolus (single most likely intervention to reverse PEA)
      3. Maximize oxygenation and ventilation (place Advanced Airway)
      4. Decompress Tension Pneumothorax
      5. Fibrinolytics if massive Pulmonary Embolism is suspected
  4. References
    1. Pediatric Resucitation
      1. http://pediatrics.aappublications.org/content/126/5/e1361.full.html
      2. (2010) Pediatrics 126(5): e1361
    2. Cardiopulmonary Resuscitation Guidelines
      1. http://www.circulationaha.org
      2. (2010) Guidelines for CPR and ECC
      3. (2005) Circulation 112(Suppl 112):IV
      4. (2000) Circulation, 102(Suppl I):86-9

Electromechanical dissociation (C0340861)

Definition (NCI) Continued electrical rhythmicity of the heart in the absence of effective mechanical function.
Definition (NCI) A phenomenon characterized by the presence of cardiac electrical rhythm without a proper response of the myocardial tissue and mechanical cardiac output. EMD may imply that there is little viable or functional myocardium. The condition may also be associated with profound hypovolemia, drug toxicity, electrolyte imbalance or mechanical obstruction to cardiac output such as pulmonary embolism, cardiac tamponade or tension pneumothorax.
Concepts Disease or Syndrome (T047)
SnomedCT 195089000, 234172002
English Card arrest-electromech disoc, PEA, Pulseless Electrical Activity, Electromechanical dissociation, Electro-Mechanical Dissociation, Electromechanical Dissociation, electromechanical dissociation (diagnosis), electromechanical dissociation, ELECTROMECHANICAL DISSOCIATION, DISSOCIATION, ELECTRO-MECHANICAL, ELECTRO-MECHANICAL DISSOCIATION, electromechanical dissociation (EMD), pulseless electrical activity, emd, Cardiac arrest with electromechanical dissociation, Electromechanical dissociation (disorder), Pulseless electrical activity, EMD, PEA - Pulseless electrical activity
Spanish Electromechanical dissociation, Actividad eléctrica sin pulso, Disociación electromecánica, disociación electromecánica (trastorno), disociación electromecánica, paro cardíaco con disociación electromecánica
Portuguese Actividade eléctrica sem pulso, Dissociação electromecânica
Italian Attività elettrica senza polso, Dissociazione elettromeccanica
German elektromechanische Dissoziation, pulslose elektrische Aktivitaet
French Dissociation électromécanique, Activité électrique sans impulsion
Dutch polsloze elektrische activiteit, elektromechanische dissociatie
Czech Elektromechanická disociace
Japanese 電気収縮解離, ﾃﾞﾝｷｼｭｳｼｭｸｶｲﾘ, ﾑﾐｬｸｾｲﾃﾞﾝｷｶﾂﾄﾞｳ, 無脈性電気活動
Hungarian Pulzus nélküli elektromos aktivitás, Electromechanikus dissociatio
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Idioventricular rhythm (C0700363)

Definition (NCI) Relating to or affecting the cardiac ventricles alone.
Concepts Pathologic Function (T046)
SnomedCT 49260003
English Idioventricular rhythm, NOS, VENTRICULAR RHYTHMS, Ventricular rhythm, NOS, RHYTHM IDIOVENTRICULAR, Rhythm, idioventricular, Idioventricular Rhythm, Idioventricular rhythm, 337 VENTRICULAR RHYTHMS, Rhythm idioventricular, IDIOVENTRICULAR RHYTHM, RHYTHM, IDIOVENTRICULAR, idioventricular rhythms, ventricular rhythm, rhythm ventricular, idioventricular rhythm, Ventricular rhythm, Idioventricular rhythm (disorder), idioventricular; rhythm, rhythm; idioventricular, Ventricular rhythm (disorder)
Italian Ritmo idioventricolare, Ritmo ventricolare
Dutch ventriculair ritme, idioventriculair; ritme, ritme; idioventriculair, idioventriculair ritme
French Rythme ventriculaire, Rythme idioventriculaire
German ventrikulaerer Rhythmus, Rhythmus idioventrikulaer
Portuguese Ritmo ventricular, Ritmo idioventricular
Spanish Ritmo ventricular, ritmo idioventricular, ritmo ventricular (trastorno), ritmo ventricular, Ritmo idioventricular
Japanese 心室調律, 固有心室調律, ｼﾝｼﾂﾁｮｳﾘﾂ, ｺﾕｳｼﾝｼﾂﾁｮｳﾘﾂ
Czech Idioventrikulární rytmus, Komorový rytmus
Hungarian Ventricularis ritmus, Idioventricularis ritmus
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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