Epinephrine (1 mg via intravenous or intraosseous line) should be delivered every three to five minutes, and treatment of reversible causes addressed. CPR should not be stopped to allow for endotracheal intubation. High-quality CPR should be continued with minimal (less than five seconds) interruption.

Therefore, if asystole is noted on the cardiac monitor, no attempt at defibrillation should be made. High-quality CPR is the mainstay of treatment and the most important predictor of a favorable outcome. Īsystole should be treated following the current American Heart Association BLS and ACLS guidelines. Neither of these studies investigated cardiac rhythms associated with cardiac arrest. This estimate was confirmed in a second study using the Get With The Guidelines-Resuscitation registry. Extrapolation of one large data set estimates approximately 200,000 in-hospital adult cardiac arrest cases per year. This, in addition to a lack of reporting consistency, makes the true number of in-hospital cardiac arrest cases largely unknown.

įewer data are available with in-hospital cardiac arrest. However, asystole had the lowest survival rate (2.3%). This is the largest number of cases (45.1%) presented in asystole. A total of 31,645 cases had a documented presenting initial rhythm. An extensive surveillance study conducted by the Centers for Disease Control and Prevention (CDC) from 2005 through 2010 evaluated 40,274 out-of-hospital cardiac arrest cases entered into the Cardiac Arrest Registry to Enhance Survival (CARES) system. Differences range from 4.6% to 11% survival-to-hospital discharge rate. Data vary in different regions of the country and various studies. Įach year, approximately 300,000 to 400,000 Americans experience a cardiac arrest outside of the hospital, with the mortality of these cases being extremely high. The American College of Emergency Physicians (ACEP) and National Association of Emergency Medical Services Physicians (NAEMSP) both recommend emergency medical services systems and have written protocols that allow for termination of resuscitation efforts by emergency medical services providers for a select group of patients in which further resuscitative measures and transport to the local emergency department would be considered futile. In out-of-hospital cardiac arrest, prolonged resuscitation efforts in a patient who presents in asystole are unlikely to provide a medical benefit. Termination of resuscitation efforts should be considered in these patients, in consultation with online medical direction, as allowed by local protocols. Asystole represents the terminal rhythm of a cardiac arrest. Victims of sudden cardiac arrest who present with asystole as the initial rhythm have an extremely poor prognosis (10% survive to admission, 0 to 2% survival-to-hospital discharge rate). Additionally, pulseless electrical activity (PEA) can cease and become asystole. Asystole typically occurs as a deterioration of the initial non-perfusing ventricular rhythms: ventricular fibrillation (V-fib) or pulseless ventricular tachycardia (V-tach). Asystole, colloquially referred to as flatline, represents the cessation of electrical and mechanical activity of the heart.

Icd 10 pulseless electrical activity