 Hi, welcome to Nursing School Explained in this video about EKG interpretation and ventricular dysrhythmias specifically about pulse less electrical activity. Let's look at this in detail. So pulse less electrical activity is also known as PEA and is a clinical situation rather than a specific dysrhythmia. And the term really gives it away pulse less electrical activity which means there can be any organized electrical activity that is underlying that we can see on the cardiac monitor but there is no mechanical contraction. So there is electrical activity that is not producing a cardiac output that means that the patient is pulse less. So on the monitor it appears like an organized rhythm but the patient will usually be pulse less and apnic and unresponsive and this is very dangerous because on the monitor the patient can appear to be looking well but if we don't assess our patient and check a pulse and actually say you know check on them we can't really figure out what's going on. And the patient may have any underlying rhythm so any rhythm is a possibility here. Pulse less electrical activity the causes for it are usually classified as the H's and T's. So H's can be hypovolemia hypoxia which are the two most common reasons of PEA and can be easily reversed. So this is something that we have to keep in the back of our minds when we are assessing a patient who is in PEA. Hydrogen ion meaning acidosis is another cause. Any potassium abnormalities so hyper or hypokalemia as well as hypoglycemia and hypothermia can be causes of PEA. Now looking at the T's it can be toxins so any kind of overdose should come to mind as well as a cardiac tamponade or a tension pneumothorax as well as thrombosis meaning coronary or pulmonary such as myocardial infarction and pulmonary embolus as well as trauma. So this is something that can happen when the patient takes a very forceful impact to the chest. Now looking at signs and symptoms again patient will be unresponsive apnoic and pulse less because all we see on the monitor is this electrical activity but there is no mechanical contraction no cardiac output hence the patient will be unresponsive apnoic and pulse less. Interventions are certainly CPR and this is a non-shockable rhythm. We only shock rhythms that are any kind of ventricular dysrhythmia such as ventricular tachycardia and ventricular fibrillation so PEA we will not shock the patient. The patient will need a nutritional intubation as well as IV access so we can treat the underlying causes of the H's and T's that we just looked at and we will follow ACLS protocols and medications to hopefully stabilize the patient. Here are some credits and references for continued practice strips so you can become very familiar and comfortable with EKG interpretation and then here is a list of my EKG interpretation playlists specifically all the ventricular dysrhythmias that we just discussed ventricular fibrillation, tachycardia and acessory. Thanks for watching nursing school explain in this video about PEA.