Cardiac resuscitation guidelines (ACLS/BCLS) advise that cardiopulmonary resuscitation should be initiated promptly to maintain cardiac output until the<unk>  can be corrected. The approach in treatment of<unk>  is to treat the underlying cause, if known (e.g. relieving a tension pneumothorax). Where an underlying cause for<unk>  cannot be determined and/or reversed, the treatment of<unk>  is similar to that for asystole. There is no evidence that external cardiac compression can increase cardiac output in any of the many scenarios of<unk> , such as hemorrhage, in which impairment of cardiac filling is the underlying mechanism producing loss of a detectable pulse. A priority in resuscitation is placement of an intravenous or intraosseous line for administration of medications. The mainstay of drug therapy for<unk>  is epinephrine (adrenaline) 1 mg every 3–5 minutes. Although previously the use of atropine was recommended in the treatment of<unk> /asystole, this recommendation was withdrawn in 2010 by the American Heart Association due to lack of evidence for therapeutic benefit. Epinephrine too has a limited evidence base, and it is recommended on the basis of its mechanism of action. Sodium bicarbonate 1meq per kilogram may be considered in this rhythm as well, although there is little evidence to support this practice. Its routine use is not recommended for patients in this context, except in special situations (e.g. preexisting metabolic acidosis, hyperkalemia, tricyclic antidepressant overdose). All of these drugs should be administered along with appropriate CPR techniques. Defibrillators cannot be used to correct this rhythm, as the problem lies in the response of the myocardial tissue to electrical impulses.
Pulseless electrical activity
Electrical alternans
Ventricular escape beat
Hyperdynamic precordium
High frequency QRS
Infradian rhythm
Junctional escape beat
Pulsus alternans