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Explain Asystole and Pulseless Electrical Activity (PEA)
The outcomes from these rhythms are generally much worse than for VT/VF, unless a readily correctable cause is identified (e.g., pneumothorax).
It is extremely important to confirm asystole - ensure that lead placement is OK and the gain is set appropriately on the monitor. It is also important not to mistake a fine VF for asystole. If there is any doubt, defibrillation must be attempted. Chest compressions and ventilation should be carried out for three minutes with each loop of the algorithm. Adrenaline is administered as described earlier. In addition, atropine 3mg IV or 6mg endotracheally may be given in asystole for complete vagal blockade.
Ed Rivers, a 3rd year medical student, was alone in the hospital ER one night. It was unusually quiet that night, and the resident was getting some much needed sleep. A patient, Mr
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