{"id":1400,"date":"2014-09-01T11:04:04","date_gmt":"2014-09-01T15:04:04","guid":{"rendered":"https:\/\/edecmo.org\/?p=1400"},"modified":"2021-11-02T19:13:45","modified_gmt":"2021-11-02T23:13:45","slug":"pseudo-pea-emd-and-such","status":"publish","type":"post","link":"https:\/\/edecmo.org\/pseudo-pea-emd-and-such\/","title":{"rendered":"EDECMO # 13 &#8211; Does Pseudo-PEA Exist and What Should You Do About It"},"content":{"rendered":"<!--powerpress_player--><div class=\"powerpress_player\" id=\"powerpress_player_7505\"><!--[if lt IE 9]><script>document.createElement('audio');<\/script><![endif]-->\n<audio class=\"wp-audio-shortcode\" id=\"audio-1400-1\" preload=\"none\" style=\"width: 100%;\" controls=\"controls\"><source type=\"audio\/mpeg\" src=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/EDECMO-20140831-13-PEA-And-Such.mp3?_=1\" \/><a href=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/EDECMO-20140831-13-PEA-And-Such.mp3\">http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/EDECMO-20140831-13-PEA-And-Such.mp3<\/a><\/audio><\/div><p class=\"powerpress_links powerpress_links_mp3\" style=\"margin-bottom: 1px !important;\">Podcast: <a href=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/EDECMO-20140831-13-PEA-And-Such.mp3\" class=\"powerpress_link_pinw\" target=\"_blank\" title=\"Play in new window\" onclick=\"return powerpress_pinw('https:\/\/edecmo.org\/?powerpress_pinw=1400-podcast');\" rel=\"nofollow\">Play in new window<\/a> | <a href=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/EDECMO-20140831-13-PEA-And-Such.mp3\" class=\"powerpress_link_d\" title=\"Download\" rel=\"nofollow\" download=\"EDECMO-20140831-13-PEA-And-Such.mp3\">Download<\/a> (Duration: 35:07 &#8212; 32.2MB)<\/p><p class=\"powerpress_links powerpress_subscribe_links\">Subscribe: <a href=\"https:\/\/edecmo.org\/feed\/podcast\/\" class=\"powerpress_link_subscribe powerpress_link_subscribe_rss\" target=\"_blank\" title=\"Subscribe via RSS\" rel=\"nofollow\">RSS<\/a><\/p><blockquote class=\"twitter-tweet\" lang=\"en\"><p>&#8220;Let me tell you, PEA is just a bunch of bullshit.&#8221; -Joe Bellezo aka <a href=\"https:\/\/twitter.com\/edecmo\">@edecmo<\/a> <a href=\"http:\/\/t.co\/2cFCjizhYe\">http:\/\/t.co\/2cFCjizhYe<\/a><\/p>\n<p>\u2014 Rob Orman (@emergencypdx) <a href=\"https:\/\/twitter.com\/emergencypdx\/status\/532744192909643777\">November 13, 2014<\/a><\/p><\/blockquote>\n<p><script src=\"\/\/platform.twitter.com\/widgets.js\" async=\"\" charset=\"utf-8\"><\/script>This is the first episode where all three of the EDECMO boys are together&#8211;yeah! Today we talk about a bunch of PEA stuff. Scott proposes 2 new terms to bring us into the modern era: <strong>PREM-pulseless with a rhythm and echocardiographic motion<\/strong> <strong>PRES-pulseless with a rhythm and echocardiographic standstill<\/strong> Joe asks why we shouldn&#8217;t just treat the latter like asystole, and he&#8217;s probably right. But what of the former? What should we do with that? Listen to the episode.<\/p>\n<h3>Jim Manning&#8217;s talk at GSA HEMS<\/h3>\n<p><a href=\"https:\/\/www.youtube.com\/watch?v=AdMQxL3yq5g&amp;list=UUGEwUVYOaAJoVbzL9-bSVmg\">On Youtube<\/a><\/p>\n<h3>Here&#8217;s the Littmann Article on PEA<\/h3>\n<p><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2014\/08\/354195.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-1403\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2014\/08\/354195.gif\" alt=\"354195\" width=\"400\" height=\"299\" \/><\/a><\/p>\n<p><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2014\/08\/A-Simplified-and-Structured-Teaching-Tool-for-the-Evaluation-and-Management-of-Pulseless-Electrical-Activity.pdf\">A Simplified and Structured Teaching Tool for the Evaluation and Management of Pulseless Electrical Activity<\/a><\/p>\n<h3>Update<\/h3>\n<p>Our friend Gregor Posen performed this <a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2014\/09\/Gregor-Posen-on-PseudoPEA.pdf\">excellent Pseudo-PEA (PREM) Paper<\/a><\/p>\n<h3>\u00a0Bibliography<\/h3>\n<p>In this episode, Joe was &#8220;Orating via the Anus&#8221; while Zack and Scott took a more evidence-based approach:<\/p>\n<ul>\n<li><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2014\/09\/Larabee-paper-on-PEA.pdf\">Larabee, T. M., et al. (2008). &#8220;A swine model of pseudo-pulseless electrical activity induced by partial asphyxiation.&#8221; Resuscitation 78(2): 196-199<\/a><\/li>\n<li><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2014\/09\/Paradis-paper-on-PEA.pdf\">Paradis, N. A., et al. (2012). &#8220;Coronary perfusion pressure during external chest compression in pseudo-EMD, comparison of systolic versus diastolic synchronization.&#8221; Resuscitation 83(10): 1287-1291.<\/a><\/li>\n<li><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2014\/09\/Prosen-PEA.pdf\">Prosen, G., et al. (2010). &#8220;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.&#8221; J Int Med Res 38(4): 1458-1467<\/a><\/li>\n<li><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2014\/09\/Paradis-Aortic-pressure-during-CPR.pdf\">Paradis, N. A., et al. (1992). &#8220;Aortic pressure during human cardiac arrest. Identification of pseudo-electromechanical dissociation.&#8221; Chest 101(1): 123-128<\/a>.<\/li>\n<li><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2014\/08\/A-Simplified-and-Structured-Teaching-Tool-for-the-Evaluation-and-Management-of-Pulseless-Electrical-Activity.pdf\">A Simplified and Structured Teaching Tool for the Evaluation and Management of Pulseless Electrical Activity<\/a><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Update<\/h3>\n<p><a href=\"http:\/\/pmid.us\/27143124\">This new study<\/a> seems to demonstrate that stratification by ecg width may not be evidence-based<\/p>\n<p>&nbsp;<\/p>\n<h3>TrackBacks<\/h3>\n<p>&#8220;PEA is just a bunch of BULLSHIT!&#8221; \u00a0Joe talks about the <a href=\"http:\/\/blog.ercast.org\/better-way-manage-pea\/\">FALLACY OF PEA<\/a> on the <a href=\"http:\/\/blog.ercast.org\/better-way-manage-pea\/\">ER Cast podcast with Rob Orman<\/a>&#8230;<\/p>\n<blockquote class=\"twitter-tweet\" lang=\"en\"><p>How we&#8217;re taught to manage PEA is BS. Here&#8217;s a way that makes sense <a href=\"http:\/\/t.co\/o8KUtblRA8\">http:\/\/t.co\/o8KUtblRA8<\/a> <a href=\"https:\/\/twitter.com\/edecmo\">@edecmo<\/a> joins ERcast to stop the madness \u2014 Rob Orman (@emergencypdx) <a href=\"https:\/\/twitter.com\/emergencypdx\/status\/538730085100945408\">November 29, 2014<\/a><\/p><\/blockquote>\n<p><script src=\"\/\/platform.twitter.com\/widgets.js\" async=\"\" charset=\"utf-8\"><\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The 3 of us discuss all things PEA<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"EDECMO # 13 - Does Pseudo-PEA Exist and What Should You Do About It http:\/\/wp.me\/p3JzC4-mA","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[4],"tags":[56],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p3JzC4-mA","_links":{"self":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts\/1400"}],"collection":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/comments?post=1400"}],"version-history":[{"count":1,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts\/1400\/revisions"}],"predecessor-version":[{"id":6831,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts\/1400\/revisions\/6831"}],"wp:attachment":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/media?parent=1400"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/categories?post=1400"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/tags?post=1400"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}