ASYSTOLE
or
PULSELESS ELECTRICAL ACTIVITY (PEA)

Assess CAB’s and Begin CPR E

Attach monitor / defibrillator Tips for successfully
managing this case:
Administer Oxygen
Continue CPR in 2 minute cycles < Don’t forget:
Stop briefly every 2 min to assess § Continue CPR
throughout
â § Monitor for
[Secondary procedures]
effective CPR -
Secure Airway & Establish IV or IO with NS or LR during CPR Use ETCo2
â § 2” compression
Given during CPR § Full recoil
Epinephrine 1mg (as soon as possible) § No rush to
intubate
Continue CPR § Start/upgrade IV
â or IO
Give Epinephrine Q 3 - 5 min § Gather focused
history
Continue CPR
While searching for reversible causes: Primary goal: continue
effective CPR followed
by rotating medications.
â
*Verbalize appropriate
Hypoxia Toxins (overdose) drug, dose, route, flush,
Evaluate for & treat and reevaluate patient
Hypovolemia Thrombosis - Pulmonary every 2 minutes.
reversible causes
anytime during the
Hydrogen ion (acidosis) Thrombosis – Coronary
Hyper/Hypokalemia Tamponade - (Cardiac) Once a rhythm is
sequence restored, maintain
Hypothermia Tension Pneumothorax ventilations as
appropriate then
â stabilize in order:
1. Rate
2. Rhythm
*If patient remains in asystole or other agonal rhythms after successful 3. Blood pressure

airway control and initial medications and no reversible causes are

identified, consider termination of resuscitative efforts

E
To work on Asystole or PEA:

Think DEAD: Do CPR, Epi, And, Do it again or

Think PEA (for both PEA and Asystole) Push Epi And… Consider the cause

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