What is the recommended treatment for pulseless electrical activity (PEA)?

Pulseless electrical activity (PEA) is a condition where there are electrical impulses in the heart, but no effective mechanical contraction occurs, leading to a lack of pulse and, consequently, no effective circulation. The treatment for PEA is aimed at restoring circulation and requires immediate and effective intervention.

The standard recommended treatment includes the initiation of cardiopulmonary resuscitation (CPR) to provide artificial circulation, ensuring that oxygenated blood is delivered to vital organs. Additionally, administering epinephrine is critical because it can help increase coronary perfusion pressure and, in turn, potentially restore a pulse and circulation. The current Advanced Cardiovascular Life Support (ACLS) guidelines emphasize the importance of these interventions in cases of PEA, marking it as the cornerstone of treatment.

Defibrillation is not indicated in PEA because there is no shockable rhythm present despite electrical activity; hence, applying electrical shocks would not be effective in this scenario. Synchronized cardioversion also does not apply since it is used for rhythms that are tachycardic and not for PEA. Although fluid resuscitation may be part of the overall management in cases of hypovolemia, it is not the first-line treatment for PEA, where immediate CPR