![]() Is it appropriate to assign code 427.5, Cardiac arrest, when PEA is documented within the health record. ![]() Heroic resuscitative measures may be unwarranted for PEA following pre-hospital traumatic arrest, regardless of CWM.Ĭardiac ultrasound in trauma FAST Pulseless electrical activity Traumatic cardiac arrest.Ĭopyright © 2019 Elsevier Ltd. Physicians are documenting pulseless electrical activity (PEA) rather than cardiac arrest, when patients are being resuscitated during a code blue situation. Although CWM is associated with survival to admission, it is not associated with meaningful survival. Overall, only one patient with PEA on arrival survived to discharge.įollowing pre-hospital traumatic cardiac arrest, PEA on arrival portends death. Asystole is the more life-threatening arrhythmia. 1.4% P < 0.001) however, no patient with CUS survived to hospital discharge. According to International Liaison Committee on Resuscitation (ILCOR), pulseless electrical activity refers to any rhythm that occurs without a detectable pulse however, it excludes ventricular fibrillation (VF) and ventricular tachycardia (VT). CWM was significantly associated with survival to hospital admission (21.9% vs. One hundred seventy-two patients (62.1%) received CUS and of these 32 (18.6%) had CWM. Sixty-three patients (22.7%) underwent resuscitative thoracotomy. PEA is defined as the absence of a palpable pulse, even though the electrocardiogram (ECG) demonstrates a synchronized electrical rhythm 7, 8. Pulseless electrical activity is not a specific rhythm. Healthcare providers need to find the potential cause and correct it, which will hopefully restore the patient’s pulse. Median CPR duration was 20.0 and 8.0 min for pre-hospital and ED, respectively. As the proportion of CAs with pulseless electrical activity (PEA) as initial rhythm is increasing, this particular subtype is the main subject of this review. Pulseless electrical activity, also commonly referred to as PEA, is a condition where the electrical activity of the heart isn’t accompanied by a palpable or effective pulse. 69 (62.7%) were injured by blunt mechanisms. ![]() The on-duty trauma surgeon directed the resuscitations and performed or supervised CUS and determined CWM.Īmong 277 patients who underwent pre-hospital CPR, 110 patients had PEA on arrival to ED. Pre-hospital management by emergency medical transport services was guided by advanced life support protocols. PEA, formerly known as electromechanical dissociation, occurs in patients who have organized cardiac electrical activity without a palpable pulse. A shock (defibrillation) is not indicated in. Trauma patients who underwent pre-hospital CPR were identified from the registries of two level-1 trauma centers. These two rhythms are non-shockable forms of cardiac arrest - Asystole and pulseless electrical activity (PEA). This purpose of this study was to evaluate the outcomes of patients with traumatic cardiac arrest presenting with PEA, with and without CWM. Some recommend cardiac ultrasound (CUS) to determine cardiac wall motion (CWM) prior to terminating resuscitation efforts. Generally considered a sign of life, PEA is the most common arrhythmia encountered following pre-hospital traumatic cardiac arrest.
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