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PEA / Asystole

Date Last Search Run: Feb 01, 2022
Table last updated: Dec 09, 2019
Data last added: Dec 12, 2016

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)      
2 (fair evidence exists)    
3 (weak evidence exists)      


Interventions

Aminophylline
Level Direction Primary Outcome Patient/Process Setting Reference
I Neutral (Yellow) Survival Patient PH-Paramedic & CCT Abu-Labaan RB., et al. Aminophylline in bradysystolic cardiac arrest: a randomised placebo-controlled trial. Lancet 2006; 367:1577-84. Medline
I Neutral (Yellow) Survival to hospital DC. Patient PH-Paramedic Hurley KF., Magee K., Green R. Aminophylline for bradyasystolic cardiac arrest in adults. Cochrane Database Syst Rev 2013; 8:CD006781. Medline
I Neutral (Yellow) ROSC Patient PH-Paramedic Mader TJ., Smithline HA., Durkin L., Scriver G. A Randomized Controlled Trial of Intravenous Aminophylline for Atropine-resistant Out-of hospital Asystolic Cardiac Arrest. Acad Emerg Med 2003; 10(3)192-7. Medline

Anticholinergic
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) mortality Patient PH-Paramedic Coon GA., Clinton JE., Ruiz E. Use of atropine for brady-asystolic prehospital cardiac arrest. Ann Emerg Med 1981; 10(9):462-7. Medline
II Neutral (Yellow) 30 day favorable neurologic outcome Patient PH-Paramedic SOS-KANTO. Atropine Sulphate for patients with Out-Of-Hospital Cardiac Arrest due to Asystole and Pulseless-electrical Activity. Circ Japan 2011; 75:580-588. Medline
III Neutral (Yellow) Survival to DC Patient PH-Paramedic Olasveengen TM., Sunde K., Brunborg C., Thowsen J., Steen PA., Wik L. Intravenous drug administration during out-of-hospital cardiac arrest: A randomized trial. JAMA 2009; 302(20):2222-9. Medline
III Opposes (Red) Survival time Patient PH-Paramedic Wang HE., Min A., Hostler D., Chang CC., Callaway CW. Differential effects of out-of-hospital interventions on short- and long-term survival after cardiopulmonary arrest. Resuscitation 2005; 67(1):69-74. Medline

Fibrinolysis
Level Direction Primary Outcome Patient/Process Setting Reference
I Neutral (Yellow) Survival to hospital discharge Patient PH-Paramedic Abu-Laban RB., et al. TPA in Cardiac Arrest with Pulseless Electrical Activity. NEJM 2002; 346: 1522-8. Medline

Transcutaneous Pacing
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) Survival to admission/ discharge Patient PH-Paramedic Cummins RO., Graves JR., Larsen MP., Hallstrom AP., Hearne TR., Ciliberti J., Nicola RM., Horan S. Out-of-Hospital Transcutaneous Pacing by EMTs in Patients with Cardiac Arrest. NJM 1993; 328(19):1377-82. Medline
II Neutral (Yellow) Presenting to the ED with a pulse Patient PH-Paramedic Hedges JR., Syverud SA., Dalsey WC., Feero S., et al. Prehospital trial of emergency transcutaneous cardiac pacing. Circ 1987; 76(6):1337-43. Medline
III Neutral (Yellow) Capture or presence of pulse Patient ED-MD Olson CM., Jastremski MS., Smith RW., Tyndall GJ., et al. External cardiac pacing for out-of-hospital brady-asystolic arrest. Am J Emerg Med 1985; 3(2):129-31. Medline
III Neutral (Yellow) Electrical capture and regained pulses Patient PH-Paramedic Paris PM., Stewart RD., Kaplan RM., Whipkey R. Transcutaneous pacing for bradysystolic cardiac arrests in prehospital care. Ann Emerg Med 1985; 14(4) 320-3. Medline
III Neutral (Yellow) Functional Pacing for Asystole Following Cardiac Arrest Patient ED-MD Tachakara SS., Jepson E., Beckette W., Barrie R. Successful Transcutaneous External Pacing for Asystole Following Cardiac Arrest. Arch Emerg Med 1988; 5:184-185. Medline
III Neutral (Yellow) Time to insertion Process ED-MD White JM., Nowak RM., Martin GB., Best R., et al. Immediate emergency department external cardiac pacing for prehospital bradyasystolic arrest. Ann Emerg Med 1985; 14(4)298-302. Medline


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