— Rob Orman (@emergencypdx) November 13, 2014
This is the first episode where all three of the EDECMO boys are together–yeah! Today we talk about a bunch of PEA stuff. Scott proposes 2 new terms to bring us into the modern era: PREM-pulseless with a rhythm and echocardiographic motion PRES-pulseless with a rhythm and echocardiographic standstill Joe asks why we shouldn't just treat the latter like asystole, and he's probably right. But what of the former? What should we do with that? Listen to the episode.
Jim Manning's talk at GSA HEMS
Here's the Littmann Article on PEA
Our friend Gregor Posen performed this excellent Pseudo-PEA (PREM) Paper
In this episode, Joe was “Orating via the Anus” while Zack and Scott took a more evidence-based approach:
- Larabee, T. M., et al. (2008). “A swine model of pseudo-pulseless electrical activity induced by partial asphyxiation.” Resuscitation 78(2): 196-199
- Paradis, N. A., et al. (2012). “Coronary perfusion pressure during external chest compression in pseudo-EMD, comparison of systolic versus diastolic synchronization.” Resuscitation 83(10): 1287-1291.
- Prosen, G., et al. (2010). “Impact of modified treatment in echocardiographically confirmed pseudo-pulseless electrical activity in out-of-hospital cardiac arrest patients with constant end-tidal carbon dioxide pressure during compression pauses.” J Int Med Res 38(4): 1458-1467
- Paradis, N. A., et al. (1992). “Aortic pressure during human cardiac arrest. Identification of pseudo-electromechanical dissociation.” Chest 101(1): 123-128.
- A Simplified and Structured Teaching Tool for the Evaluation and Management of Pulseless Electrical Activity
This new study seems to demonstrate that stratification by ecg width may not be evidence-based