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Brought to you by Washington University and NAEMSP, our mission is to provide education to the EMS practitioner who is always asking “but why?” using physician-level expert commentary, queries from paramedics, and some good old fashioned humor.

Jun 30, 2021

For paramedics click her for CEU credits.

Brought to you by Urgent Admin which is an intuitive one-touch solution that connects in-field clinicians and medical directors in real-time,

this But Why EMS podcast covers the sneaky chameleon known as Pseudo PEA. 

Hear the But Why EMS Podcast team discuss with:

Dr. Ian Ferguson 


Dr. Keith Marill 

What Pseudo-PEA is, how to diagnose it, and more!

Click here to check it out today!

Thank you for listening!

Hawnwan Philip Moy MD 

Gina Pellerito EMT-P

John Reagan EMT-P

Noah Bernhardson MD

Works Cited

1. Mehta C, Brady W. Pulseless electrical activity in cardiac arrest: electrocardiographic presentations and management considerations based on the electrocardiogram. Am J Emerg Med. 2012;30(1):236-9.

2. Littmann L, Bustin DJ, Haley MW. A simplified and structured teaching tool for the evaluation and management of pulseless electrical activity. Med Princ Pract. 2014;23(1):1-6.

3. Bergum D, Skjeflo GW, Nordseth T, Mjolstad OC, Haugen BO, Skogvoll E, et al. ECG patterns in early pulseless electrical activity-Associations with aetiology and survival of in-hospital cardiac arrest. Resuscitation. 2016;104:34-9.

4. Nordseth T, Olasveengen TM, Kvaloy JT, Wik L, Steen PA, Skogvoll E. Dynamic effects of adrenaline (epinephrine) in out-of-hospital cardiac arrest with initial pulseless electrical activity (PEA). Resuscitation. 2012;83(8):946-52.

5. Hogan TS. External cardiac compression may be harmful in some scenarios of pulseless electrical activity. Med Hypotheses. 2012;79(4):445-7.

6. Atropine sulfate for patients with out-of-hospital cardiac arrest due to asystole and pulseless electrical activity. Circ J. 2011;75(3):580-8.

7. Gaspari R, Weekes A, Adhikari S, Noble V, Nomura JT, Theodoro D, et al. A retrospective study of pulseless electrical activity, bedside ultrasound identifies interventions during resuscitation associated with improved survival to hospital admission. A REASON Study. Resuscitation. 2017;120:103-7.

8. Testa A, Cibinel GA, Portale G, Forte P, Giannuzzi R, Pignataro G, et al. The proposal of an integrated ultrasonographic approach into the ALS algorithm for cardiac arrest: the PEA protocol. Eur Rev Med Pharmacol Sci. 2010;14(2):77-88.

9. Badra K, Coutin A, Simard R, Pinto R, Lee JS, Chenkin J. The POCUS pulse check: A randomized controlled crossover study comparing pulse detection by palpation versus by point-of-care ultrasound. Resuscitation. 2019;139:17-23.

10. Paradis N.A., Martin G.B., Goetting M.G., Rivers E.P., Feingold M., Nowak R.M.Aortic pressure during human cardiac arrest. Identification of pseudo-electromechanical dissociation. Chest, 101 (1992), pp. 123-128