Epi 1mg q3-5min
Three major mechanisms of PEA (3 & 3 Rule)
Tension pneumothorax
Cardiac tamponade
Massive Pulmonary embolism
Hypovolemia
Hypoxemia
Hydrogen ion (i.e. acidemia)
Hypo/hyperkalemia
Hypothermia
Tension Pneumothorax
Cardiac tamponade
Toxins
Thrombosis, pulmonary
Thrombosis, coronary
Differential based on QRS being narrow or wide and aided by ultrasound
Mechanical RV Problem – Ultrasound should show hyperdynamic LV and potential cause
Cardiac tamponade
Tension pneumothorax
Mechanical hyperinflation
Pulmonary embolism
Acute MI with myocardial rupture
Metabolic LV Problem – Ultrasound should show hypokinetic LV
Severe hyperkalemia
Sodium-channel blocker toxicity (Ex. Tricyclic (TCA) toxicity)
Agonal rhythm
Acute MI with pump failure
Pulseless arrest
Spinal shock
Heat syncope
Cardiogenic shock
Electrical storm
Neurogenic shock
Hemorrhagic shock
Undifferentiated shock 