NREMT Paramedic Cognitive ExamCardiology & ResuscitationEasy
A 45-year-old male collapses during a basketball game. Bystanders initiated CPR immediately. Upon arrival, the cardiac monitor shows a waveform indicating organized electrical activity but no palpable pulse. Which of the following rhythms is MOST likely present?
- AVentricular Tachycardia (VT) with a pulse
- BVentricular Fibrillation (VF)
- CAsystole
- DPulseless Electrical Activity (PEA)
Show answer & explanationAnswer & explanation
Correct answer: D. Pulseless Electrical Activity (PEA)
Pulseless Electrical Activity (PEA) is defined as organized electrical activity on the cardiac monitor that is not accompanied by a palpable central pulse. The scenario describes exactly this: organized electrical activity (a waveform) but no palpable pulse despite CPR.
Why the other options are wrong
- A. Ventricular Tachycardia (VT) with a pulse implies a palpable pulse, which is explicitly absent in the scenario.
- B. Ventricular Fibrillation (VF) is chaotic, disorganized electrical activity, not organized electrical activity.
- C. Asystole is the absence of all electrical activity, appearing as a flat line on the monitor, not an organized waveform.
Pulseless Electrical Activity (PEA)
A condition in cardiac arrest where electrical activity is present on the ECG monitor, but there is no mechanical contraction of the heart and thus no palpable pulse.
- Organized electrical activity on monitor.
- No palpable pulse.
- Requires immediate CPR and identification of reversible causes.
Memory trick: No Pulse? Check the Monitor, Then Act!