Snapshot A 42-year-old man falls to the ground abruptly. Prior to the fall, he felt lightheaded and experienced palpitations. Chest compressions are immediately performed and he was placed on a Lucas device en route to the emergency department. In the emergency department, a defibrillator is placed on the patient, which does not show a shockable rhythm. The electrocardiogram demonstrates electrocardiographic activity but he does not have a pulse. The patient is given epinephrine in addition to chest compressions. After 1 hour of management, he returns to spontaneous circulation. (Pulseless electrical activity) Introduction Definition login to view 6 more bullets Etiology The H's and T's login to view 9 more bullets Presentation Symptoms login to view 1 more bullet Physical exam login to view 1 more bullet Studies Electrocardiogram login to view 1 more bullet Treatment Initiate advanced cardiovascular life support (ACLS) login to view 9 more bullets Manage the underlying cause (H's and T's) login to view 21 more bullets Complications If systemic perfusion is not restored, will inevitably lead to death