Identifying PEA/Asystole

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bill213

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Hello, so, from an aspiring EMS Professional standpoint, how can I identify PEA/Asystole (non-shockable) from V-FIB, etc. (shockable)? I was told that radial pulses are a big indicator.
 
You need a rhythm strip to determine rhythm. The presence or lack of a pulse does not indicate on it's own what rhythm the patient is in nor if electricity is the correct therapeutic intervention.
 
If you have an AED it will do it for you. If you are able to read an EKG rhythm you need to know what our shockable rhythms are.

The presence of a pulse tells if if the patient is in PEA or has an actual pulse with a blood pressure.
 
So, if an AED or EKG is not available during that, you basically can't tell, right?
 
You can print out a 3 lead, but essentially you are correct.

A physical assessment can provide evidence towards certain rhythms as @NPO mentioned regarding the assessment of PEA by whether the patient has a pulse, but the lack of a pulse doesn't confirm that they are in PEA, they could be in asystole or a non-perfusing rhythm like V-fib.

Likewise If a patient has an apical heart rate of 250 I can safely assume that the patient is in SVT of some kind, but I couldn't determine between A-fib with RVR, re-entry nodal rhythms, or A-flutter for example.
 
Yes; with a HR of 250 you can't determine if they are in A-fib with or without RVR, or A-Flutter.
That is when Adenosine comes in handy, hit print, push it and watch what comes out on the printer. Usually pre-hospital, just be careful how you document it: Medical Directors don't like it when you state that you pushed Adenosine to find out what rhythm the patient was in. (Even though my medical director taught us how to do that).
Document they patient looked like they were in SVT and after you pushed Adenosine or cardioverted the patient you found _______ rhythm.
 
DesertMedic66 said:
If you have an AED it will do it for you. If you are able to read an EKG rhythm you need to know what our shockable rhythms are.

The presence of a pulse tells if if the patient is in PEA or has an actual pulse with a blood pressure.
Click to expand...
Some AEDs display the rhythm they are looking at on a display. Kern County FD has these ones and it's helpful when you first walk up to glance down and have an idea what you're working with.
 
Could anyone give me an example or show an image of asystole/PEA rhythm on display for reference purposes, please?
 
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