EDECMO # 13 – Does Pseudo-PEA Exist and What Should You Do About It

What this episode covers

"Let me tell you, PEA is just a bunch of bullshit." -Joe Bellezo aka @edecmo http://t.co/2cFCjizhYe — 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 On Youtube Here's the Littmann Article on PEA A Simplified and Structured Teaching Tool for the Evaluation and Management of Pulseless Electrical Activity Update Our friend Gregor Posen performed this excellent Pseudo-PEA (PREM) Paper Bibliography 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 Update This new study seems to demonstrate that stratification by ecg width may not be evidence-based TrackBacks "PEA is just a bunch of BULLSHIT!" Joe talks about the FALLACY OF PEA on the ER Cast podcast with Rob Orman ... How we're taught to manage PEA is BS. Here's a way that makes sense http://t.co/o8KUtblRA8 @edecmo joins ERcast to stop the madness — Rob Orman (@emergencypdx) November 29, 2014

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