Recognition and Treatment of Pulseless Electrical Activity (PEA)

In this webinar the presenter will explain how to recognise and treat an unusual cardiac arrest, caused by the arrhythmia Pulseless Electrical Activity (PEA). In the past cardiac arrests caused by Ventricular Tachycardia (VT) and Ventricular Fibrillation (VF) were the most common presenting life-threatening arrhythmias. VT and VF have distinct characteristics which made them easy to recognise.
CPD HOURS: 1
 Registration Year 2024-2025

Course Content

In this webinar the presenter will explain how to recognise and treat an unusual cardiac arrest, caused by the arrhythmia Pulseless Electrical Activity (PEA). In the past cardiac arrests caused by Ventricular Tachycardia (VT) and Ventricular Fibrillation (VF) were the most common presenting life-threatening arrhythmias. VT and VF have distinct characteristics which made them easy to recognise.

Unfortunately in recent years the incidence of PEA has markedly increased. It is a life-threatening arrhythmia that is more difficult to recognise and treat and is associated with a higher mortality rate. The treatment approach is markedly different from VT/ VF.

Pulseless Electrical Activity (PEA) is occurring more frequently in the wards and therefore all nurses must have an understanding of this arrhythmia. It is discussed in length in all Advanced Life Support Courses, but the content must now be made available for all general wards nurses, especially those working in Telemetry wards. If it is not recognised immediately it is linked with a very high mortality rate.

PEA is a life-threatening situation where there is electrical activity in the heart, which may even look normal on the monitor but does not produce a pulse. This means the heart is not pumping blood effectively despite having electrical signals. In PEA, the heart either does not contract or there is insufficient cardiac output to generate a pulse. The clinician may look at the monitor and note a relatively normal rhythm with a heart rate, but the patient is unconscious and has no pulse. The most common cause is severe blood loss but can also occur from a variety of conditions such as hypoxia, electrolyte imbalances, and cardiac tamponade.

PEA is classified as a non-shockable rhythm, meaning defibrillation is not effective and treatment focuses on CPR and addressing the underlying cause. If you are attending an ALS course in the future this webinar will assist you and if you are a nurse who works in cardiology, ED or a telemetry ward, this is important knowledge for you. The main concept from this webinar is the patient is pulseless, in cardiac arrest but the cardiac monitor may not alarm as the rhythm looks normal.

Why this session may be relevant to your work

Nurses need to be able to detect acute deterioration of a patient. With the increasing incidence of PEA all Nurses and Midwives must have knowledge to detect a PEA and initiate treatment.

Learning Outcomes

In this session you will:
  • Identify which organisation in Australia and New Zealand provides guidance on protocols to be used in a cardiac arrest 
  • Recognise the characteristics of Pulseless Electrical Activity (PEA) and why it might be challenging to recognise
  • Demonstrate knowledge of the common causes of PEA
  • Demonstrate knowledge of the treatment of PEA compared to VT /VF

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Anne Evans-Murray

R.N., BHlthSc, MACCCN, Grad.Dip Ed, MEd, Dip Counselling, GradCertCritCare, CertIV Training and Assessment, CertIV in Mediation
Anne has a passion for teaching which she does in an unpretentious way that ensures you will not only understand and retain what she presents but will enjoy this learning experience. She has extensive experience of over 26 years lecturing for Gold Coast Health District and Griffith University.