Cardiovascular Medicine Book

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Pulseless Electrical ActivityAka: Electromechanical Dissociation, Idioventricular Rhythm, Bradyasystolic Rhythm

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  1. See Also
    1. Guidelines for Emergency Cardiovascular Care
  2. Causes (Mnemonic: 4H TAPE MD, or 4T+4H)
    1. Hypovolemia
    2. Hypoxia
    3. Hypothermia
    4. Hyperkalemia
    5. Hydrogen ion (Acidosis)
    6. Tension Pneumothorax or Cardiac Tamponade
    7. Thrombus (Pulmonary Embolus, Myocardial Infarction)
    8. Toxins or Tablets (Drug Overdose)
      1. Tricyclic Antidepressant Overdose
      2. Digitalis Toxicity
      3. Beta Blocker overdose
      4. Calcium Channel Blocker overdose
  3. Pediatric Management
    1. See Asystole
  4. Adult Management
    1. CPR
    2. Intubation
    3. IV Access
    4. Medications
      1. Epinephrine 1 mg IV push q3-5 minutes
      2. Atropine 1 mg IV q3-5 min
        1. Consider for Bradycardia
        2. Total Dose Maximum: 3 mg
    5. Assess blood flow
      1. Doppler ultrasound
      2. End-tidal CO2
      3. Echocardiography
      4. Arterial Line
    6. Consider causes as above and treat appropriately
      1. Hyperventilate
      2. Fluid bolus
      3. Consider Sodium Bicarbonate 1 mEq/kg

Electromechanical dissociation (C0340861)

Definition (NCI)Continued electrical rhythmicity of the heart in the absence of effective mechanical function.
Definition (NCI)A phenomenon characterized by the presence of cardiac electrical rhythm without a proper response of the myocardial tissue and mechanical cardiac output. EMD may imply that there is little viable or functional myocardium. The condition may also be associated with profound hypovolaemia, drug toxicity, electrolyte imbalance or mechanical obstruction to cardiac output such as pulmonary embolism, cardiac tamponade or tension pneumothorax.
ConceptsDisease or Syndrome (T047)
EnglishCardiac arrest with electromechanical dissociation, Electro-Mechanical Dissociation, Electromechanical dissociation, EMD, PEA, PEA - Pulseless electrical activity, Pulseless electrical activity
Spanishdisociacion electromecanica, paro cardiaco con disociacion electromecanica
Parent ConceptsCardiovascular finding (C0425560), Cardiac Arrest (C0018790), Duplicate concept (C1274013)
SourcesMTH, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Idioventricular rhythm (C0700363)

Definition (NCI)Relating to or affecting the cardiac ventricles alone.
ConceptsPathologic Function (T046)
EnglishIdioventricular Rhythm, RHYTHM IDIOVENTRICULAR, Ventricular rhythm
Spanishritmo idioventricular, ritmo ventricular
Parent ConceptsCardiovascular finding (C0425560), Ventricular arrhythmia (C0085612)
SourcesCST, MTH, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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