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Pulseless Electrical Activity (PEA)

Pulseless Electrical Activity (PEA) Pronunciation: P-E-A (pē-ē-ā)

Definition: Pulseless Electrical Activity (PEA) refers to a clinical condition where an individual has an organized heart rhythm – as detected on an electrocardiogram (ECG) – but no detectable pulse. It indicates a severe condition that requires immediate medical attention, as the heart is not effectively pumping blood despite electrical activity.

What is Pulseless Electrical Activity (PEA)?


PEA is a critical emergency situation often seen in cardiac arrest cases. The heart’s electrical activity may appear normal or nearly normal on an ECG, but the mechanical function of the heart is compromised, and it fails to generate a pulse or adequate blood flow.

Key Facts about Pulseless Electrical Activity (PEA):

  • PEA often results from a severe systemic problem, such as hypoxia, hypovolemia, hypothermia, hyperkalemia, acidosis, or thrombosis.
  • It is a common cause of cardiac arrest and is associated with a high mortality rate.
  • PEA requires immediate treatment with cardiopulmonary resuscitation (CPR) and addressing the underlying cause.
  • Medications such as epinephrine may be administered as part of advanced cardiac life support (ACLS).

Pulseless Electrical Activity (PEA) Recognition & Treatment

How is PEA recognized?

PEA is recognized by the presence of organized or semi-organized electrical activity on ECG in the absence of a palpable pulse. This finding should prompt immediate initiation of resuscitation efforts.

How is PEA treated?

PEA is treated primarily with high-quality CPR, with the focus on identifying and treating the underlying cause. Some of the potential treatments may include:

  • Supplemental oxygen and ventilation for hypoxia.
  • Fluids or blood products for hypovolemia.
  • Warming measures for hypothermia.
  • Medications for electrolyte imbalances or overdoses.

Frequently Asked Questions About PEA

What causes Pulseless Electrical Activity?

PEA is usually caused by a severe systemic problem, such as hypoxia (low oxygen), hypovolemia (low blood volume), hypothermia (low body temperature), hyperkalemia (high potassium levels), acidosis (high acid levels), or thrombosis (blood clot).

Can PEA be reversed?

PEA can sometimes be reversed if the underlying cause is identified and treated promptly. However, it often indicates a serious problem and is associated with a high mortality rate.


  1. Mayo Clinic. (n.d.). Pulseless Electrical Activity. Retrieved July 25, 2023, from