Pulseless Electrical Activity (PEA)

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Have any of you ever seen this in the NICU?

I'm not at all familiar with it, I vaguely remember hearing about it in nursing school, but that's it.

We just had a kid that this happened to ...... through the whole code I'm just standing there like "what the heck is going on?!" (kid has no HR when you listen, yet the monitor is showing a NSR of 140 bpm)

One of the scariest things I've seen :o

Geez, that's awful, but was she on a monitor?

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Geez, that's awful, but was she on a monitor?

yep...it never alarmed. The only thing that would have helped was if the baby would have been on a pulse ox.

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Specializes in NICU.
We lost a baby a while ago that went into PEA. Chronic gastroschisis kiddo that was having some emesis/feeding issues. Long story short...Nec. It hit her really fast...KUB's didn't show anything...they thought she was just being a gut kid. Obviously she was fussy... was put in a swing and finally calmed down. The monitor never alarmed. Feeding time came and when the nurse went to check on her she was gone. Long horrible code. It was very scary to think something like that can happen. It really makes me never want to put a fussy kid in a swing, dim the lights, and go chat with my roommate till the next feed. :o

Wow, that's really scary!

Yeah, a lot of those gastro kids aren't on pulse oximeters, if they're term kids and haven't had any respiratory issues.

Like I mentioned in our situation, the HR was in the 120s-140s .... so the monitor wasn't going to alarm. The only things that clued us in was the art line and the pulse ox.

Scary stuff.

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I've never seen this in neonates after almost 25 years, but a coworker with a few more years has seen it once. Our nurse practitioner said it is rare in neonates and common in adults. In the 80's we used to call it EMD which I think stood for Electro-mechanical disassociation.

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Specializes in NICU.
we used to call it EMD which I think stood for Electro-mechanical disassociation.

That's exactly what our neo called it. He came in and saw what was going on .... said "he's in EMD, call a code".

I'm still curious to find out what caused it though. I wonder why it's so rare in neonates, but more common in adults?

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