What is the definition of "pulseless electrical activity" (PEA)?

Pulseless electrical activity (PEA) is defined as a condition where there is electrical activity in the heart but no detectable pulse. This means that while the heart may show organized electrical activity on an electrocardiogram (ECG), it is not contracting effectively enough to produce a palpable pulse due to a variety of underlying issues. These can include severe hypovolemia, cardiac tamponade, tension pneumothorax, or metabolic disturbances, among others. The lack of a pulse despite electrical activity indicates that the heart is not functioning adequately to support circulation.

This distinction is crucial in emergency medicine and resuscitation because it influences the approach to treatment. While cardiopulmonary resuscitation (CPR) is initiated, clinicians must identify and correct the underlying causes of PEA to restore effective heart function and pulse. Other options do not capture the full clinical picture of PEA accurately. For example, the absence of electrical activity in the heart would not classify as PEA, and simply saying it requires defibrillation is misleading because PEA does not respond to defibrillation, which is primarily effective in cases of shockable rhythms like ventricular fibrillation or pulseless ventricular tachycardia.