|REGULARITY||The rhythm will be a nearly flat line.|
|RATE||There is no rate.|
|P WAVE||There are no P waves present.|
|PR Interval||PRI is unable to be measured due to no P waves being present|
|QRS||There are no QRS complexes present.|
Pulseless electrical activity (PEA) and asystole are related cardiac rhythms in that they are both life threatening and NOT shockable. Asystole is a flat-line ECG. There may be subtle movement away from baseline (drifting flat-line) but there is no perceptible cardiac electrical activity. Always ensure a reading of asystole is not an user or technical error. Make sure patches have good contact with the patient, leads are connected, gain is set appropriately, and the power is on. Pulseless electrical activity is one of many waveforms by ECG (including sinus rhythm), without a detectable pulse. Pulseless electrical activity may include any pulseless waveform with the exception of VF (VF), VT (VT), or asystole.
Hypovolemia and hypoxia are the two most common causes of PEA. They are also the most easily reversible and should be at the top of any differential diagnosis.
If the patient has return of spontaneous circulation (ROSC), proceed to Post-Cardiac Arrest Care. Atropine is no longer recommended in cases of PEA or asystole.