Advanced Cardiac Life Support - Rhythms

Asystole - Flat line or no electrical activity on an ECG monitor

After performing the initial ABC survey and secondary ABC survey, it is determined that the patient is in Asystole. A large percentage of patients with this lack of rhythm do not survive. According to page 109 of the ACLS provider manual "this occurs in almost exclusively in severely ill persons." The manual goes on to recommend that prolonged efforts to resuscitate a patient in asystole are unnecessary, futile and often unethical and CPR and resuscitation should stop after 10 minutes of continued asystole with no potential reversible cause. Reversible conditions associated with asystole are:

Hypovolemia

Hypoxia

Acidosis

Hyperkalemia / hypokalemia

Hypothermia

• Tablets or overdose
• Cardiac Tamponade
• Tension pneumothorax
• CoronaryThrombosis ( Acute coronary syndrome )
• Pulmonary Thrombosis

It is important to check for true asystole by:

• Checking led and cable connections
• Making sure the monitor is on and the gain is up
• Verify asystole in another lead

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Last Updated 12/12/2005 2:20:41 PM