Vented Patient PEA

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So this might sound like a stupid question but . . .

how do you know your patient went into a PEA if he's on a vent?

We were told in school that one of the only ways to tell if they're having a PEA is if they stop breathing. . .

Maybe I'm just not thinking clearly about it? :confused:

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No pulse

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Specializes in PICU, Sedation/Radiology, PACU.

I would hope that anyone on a ventilator is also being monitored in other ways- EKG, pulse ox, etc. The EKG would detect the change in heart pattern and rate. The pulse ox would alarm as the Sp02 decreases.

You would also notice cyanosis, and of course, there would be no pulse.

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Specializes in Med/Surg, Ortho, ASC.

Pulseless Electrical Activity

"We were told in school that one of the only ways to tell if they're having a PEA is if they stop breathing. . . "

Not a primary indication. You will learn to prioritize your observations. The lack of pulse will always take front and center stage.

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Specializes in Medical/surgical, ICU.

Our EKG monitors do not always catch PEA. We notice first if the patient has an art line that suddenly loses wave form.

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Specializes in OB, Med/Surg, Ortho, ICU.

PEA-Pulseless Electrical Activity. The others are right-check for a pulse, look for your arterial pressure (which would detect no circulation), or SaO2.

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Specializes in OB, Med/Surg, Ortho, ICU.

Looks like I repeated some things-sorry! I'll have to remember to refresh for responses!

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wait-- pea is pulseless electrical activity, and you want to know how to know whether your patient is pulseless? or am i missing something?:idea:

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wait-- pea is pulseless electrical activity, and you want to know how to know whether your patient is pulseless? or am i missing something?:idea:

i guess i just want a quick way to tell without walking all the way into the room. for instance on my hourly rounds at night i look it, see that they're breathing, and ask if they need anything (if they're awake).

guess for these patients i'll just walk all the way in and check a pulse. nbd.

thanks for all that responded! :)

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Specializes in Med/Surg, Ortho, ASC.

"I guess I just want a quick way to tell without walking all the way into the room."

OMG. Seriously??? INCOMING!!

:sofahider

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Specializes in Psychiatry, ICU, ER.

PEA, as others have noted, is characterized by a lack of pulse. Of course, they won't be breathing either. Note that EKG monitoring will not always tell you if you have PEA, which can look like a perfectly nice normal sinus rhythm.

I guess I just want a quick way to tell without walking all the way into the room.

That's pretty funny. If you can find a way to administer antibiotics from the doorway and deliver meal trays with your mind, let me know. :)

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Specializes in OB, ER.

I think her question is very valid. If a person is in a room on a vent you are not constantly standing there with a hand on their pulse. If you just glance in the room and peek at the monitor all may look well when really it isnt'. Good rhythm on the monitor, still breathing...yep things look ok from a distance!

You will be able to tell because quickly the sat and bp will drop. People aren't in PEA too long before they are in asystole.

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