Scenario: A patient is in cardiac arrest. CPR is in progress, and the monitor shows pulseless electrical activity (PEA).

Initial Assessment:

• Responsiveness: Unresponsive
• Breathing: Apneic (not breathing)
• Pulse: No pulse palpated
• Rhythm (on monitor): PEA

Actions:

CPR is ongoing.

Questions:

1. What is the primary focus of treatment in PEA?

   • a) Defibrillation
   • b) Identifying and treating the underlying cause
   • c) Administering antiarrhythmic medications
   • d) Pacing

2. What medication is recommended in PEA?

   • a) Epinephrine
   • b) Atropine
   • c) Adenosine
   • d) Amiodarone

3. What are some common reversible causes of PEA (the “Hs and Ts”)?

   • a) Hypovolemia, hypoxia, hydrogen ion (acidosis), hyper/hypokalemia, hypothermia
   • b) Tension pneumothorax, tamponade (cardiac), toxins, thrombosis (pulmonary/coronary)
   • c) Both a and b
   • d) None of the above