What is the difference between asystole and pulseless electrical activity (PEA) on telemetry?

What is the difference between asystole and pulseless electrical activity (PEA) on telemetry?

• A. Asystole shows no electrical activity; PEA shows organized electrical activity without a detectable pulse; both require CPR and ACLS
• B. PEA shows organized electrical activity with a pulse
• C. PEA shows no electrical activity
• D. Asystole shows organized electrical activity

Answer: (A)

The main idea is separating electrical activity from mechanical output on the monitor. Asystole means there is no electrical activity at all—a flat trace with no QRS complexes, indicating no cardiac contraction and no usable output. Pulseless electrical activity means there is some organized electrical activity visible on the monitor, but the heart isn’t effectively pumping, so no pulse is present. In other words, PEA shows electrical rhythm without perfusion, while asystole shows no electrical rhythm or activity. Because both represent cardiac arrest, the response is immediate high-quality CPR and ACLS maneuvers, including identifying reversible causes. Defibrillation is not used for either until a rhythm that is actually shockable appears.

The main idea is separating electrical activity from mechanical output on the monitor. Asystole means there is no electrical activity at all—a flat trace with no QRS complexes, indicating no cardiac contraction and no usable output. Pulseless electrical activity means there is some organized electrical activity visible on the monitor, but the heart isn’t effectively pumping, so no pulse is present. In other words, PEA shows electrical rhythm without perfusion, while asystole shows no electrical rhythm or activity.

Because both represent cardiac arrest, the response is immediate high-quality CPR and ACLS maneuvers, including identifying reversible causes. Defibrillation is not used for either until a rhythm that is actually shockable appears.