NREMT Paramedic Cognitive ExamCardiology & ResuscitationMedium
A 70-year-old male with a history of heart failure is found unresponsive. CPR is in progress. The cardiac monitor shows a regular rhythm at a rate of 70 bpm, but no palpable pulse. What is the most likely cardiac arrest rhythm?
- AVentricular Fibrillation (VF)
- BAsystole
- CPulseless Electrical Activity (PEA)
- DPulseless Ventricular Tachycardia (pVT)
Show answer & explanationAnswer & explanation
Correct answer: C. Pulseless Electrical Activity (PEA)
Pulseless Electrical Activity (PEA) is defined as organized electrical activity on the ECG monitor, but without a palpable pulse. In this scenario, a regular rhythm at 70 bpm with no pulse perfectly matches the definition of PEA.
Why the other options are wrong
- A. VF is chaotic, disorganized electrical activity, not a regular rhythm.
- B. Asystole is the absence of all electrical activity (a flat line).
- D. pVT is an organized wide-complex tachycardia, but still too fast and distinct from a regular 70 bpm rhythm.
Pulseless Electrical Activity (PEA)
Pulseless Electrical Activity (PEA) is a clinical condition of cardiac arrest characterized by organized electrical activity on the electrocardiogram (ECG) monitor, but without any palpable pulse or effective cardiac contraction.
- ECG shows a rhythm that should produce a pulse, but no pulse is found.
- Patient is unresponsive and apneic.
- Non-shockable rhythm.
- Management focuses on high-quality CPR, epinephrine, and identifying/treating reversible causes (H's and T's).
Memory trick: Shock or Not? Check the Rhythm Dot!