Treating cardiac thrombosis usually involves an intervention designed to resolve the clot, such as primary percutaneous coronary intervention or coronary angiography. Ventilation and restoring oxygen levels is the best treatment for hypoxia. Low oxygen levels can occur for many different reasons, including asthma, anemia, drowning and many other conditions. The root cause of hypovolemia should be addressed as well. The recommended treatment for hypovolemia involves infusion of blood products and/or warmed crystalloids. This may occur for many different reasons, from vomiting to blood loss. Hypovolemia occurs when extracellular fluid levels in the body drop too low. When hypothermia is the cause of PEA, rewarming of the patient’s body is the recommended treatment to return temperature to normal. Hypothermia occurs when body temperature drops to a dangerous level. The treatment of hyperkalemia involves protecting the heart, shifting potassium into cells and taking steps to remove potassium from the body. Hyperkalemia occurs when potassium levels are dangerously high. Administration of potassium is recommended in cases of hypokalemia. Hypokalemia is a common electrolyte disturbance that can cause PEA when potassium levels drop to dangerous lows. if the patient is suffering from respiratory acidosis, ventilation is the recommended treatment. If the patient is suffering from metabolic acidosis, the treatment may involve sodium bicarbonate administration. Hydrogen Ion (Acidosis)Īcidosis can be quickly confirmed with an arterial blood gas. The basic treatment recommendations for each of these potential causes of PEA are detailed below. After the factors contributing to the development of PEA have been identified, treatment of PEA typically involves reversing the cause of the event. Epinephrine should also be administered every three to five minutes while the cause of the PEA is identified. Regardless of the cause of PEA, the first step in treating this condition is always to begin chest compressions based on the advanced cardiac life support protocol. These issues are broken down into five H’s and five T’s. The 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care recommends that healthcare providers assess 10 different possible issues that could cause PEA when this type of cardiac arrest occurs. When PEA is being treated in a hospital setting, the recommended course of action typically depends on the suspected cause of cardiac arrest. The treatment recommendations for patients with pulseless electrical activity vary based on whether the patient is in the hospital or outside of the hospital at the time of the event, as well as the cause of the PEA. The survival rate is even lower when PEA presents after countershock instead of as the initial rhythm. Studies show that only 2 to 5 percent of patients who experience PEA outside of the hospital will survive. Pulseless electrical activity is associated with a poor prognosis for patients. Studies indicate that pulseless electrical activity accounts for as many as 40 percent of cardiac arrests in the hospital and as many as 40 percent of cardiac arrest events outside of the hospital. Patients may experience PEA after a drug overdose, myocardial infarction, trauma, hypothermia, hypoglycemia, cardiac tamponade, pulmonary embolism, or sepsis. Possible causes of pulseless electrical activity include ionic perturbations, metabolic acidosis, ischemia and hypoxia. Pulseless electrical activity may occur because of any issue that inhibits the shortening of myocardial fibers, thus preventing mechanical contractions.
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