When treating PEA, what is the highest priority intervention?

In the context of treating pulseless electrical activity (PEA), the highest priority intervention is providing good chest compressions with minimal interruptions. This is essential because PEA is a situation where the electrocardiogram shows electrical activity of the heart, but the heart is not effectively pumping blood. Therefore, the focus must shift immediately to mechanical circulation.

Effective chest compressions help to generate blood flow to vital organs, particularly the brain and heart, which are critically dependent on oxygenated blood. Compressions should be high quality—compressed at the correct rate and depth, and with minimal interruptions to maintain perfusion pressure. This emphasis on chest compressions is in line with current advanced cardiac life support (ACLS) guidelines, which prioritize circulation over other interventions in cases of PEA.

While administering epinephrine, assessing airway patency, or using an AED are all important components of advanced resuscitation, the immediate goal during PEA is to ensure that the body is receiving some level of circulation through effective chest compressions. This approach maximizes the chances of successful resuscitation and recovery.