Emergent Management of Asystole Clinical Presentation

  • Author: Richard M Caggiano, MD, FACEP; Chief Editor: David FM Brown, MD   more...
 
Updated: Aug 8, 2011
 

History

Immediate diagnosis of asystole requires the recognition of a full cardiac arrest and a confirmed flat-line rhythm in 2 perpendicular leads. Lightheadedness or syncope may precede asystole when it follows a bradyasystolic rhythm.

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Physical Examination

If the rhythm is truly asystole and has been present for more than several seconds, the patient will be unconscious and unresponsive. A few agonal (final gasping) breaths may be noted, but detectable heart sounds and palpable peripheral pulses are absent.

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Contributor Information and Disclosures
Author

Richard M Caggiano, MD, FACEP  Adjunct Faculty, Department of Medicine, University of Washington School of Medicine; Director of Emergency Services, Chief Medical Officer, and Assistant Director of Trauma Services, Pullman Regional Hospital; Medical Physician Director, Whitman County, Washington

Richard M Caggiano, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Edward Bessman, MD  Chairman, Department of Emergency Medicine, John Hopkins Bayview Medical Center; Assistant Professor, Department of Emergency Medicine, Johns Hopkins University School of Medicine

Edward Bessman, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Gary Setnik, MD  Chair, Department of Emergency Medicine, Mount Auburn Hospital; Assistant Professor, Division of Emergency Medicine, Harvard Medical School

Gary Setnik, MD is a member of the following medical societies: American College of Emergency Physicians, National Association of EMS Physicians, and Society for Academic Emergency Medicine

Disclosure: SironaHealth Salary Management position; South Middlesex EMS Consortium Salary Management position; ProceduresConsult.com Royalty Other

Chief Editor

David FM Brown, MD  Associate Professor, Division of Emergency Medicine, Harvard Medical School; Vice Chair, Department of Emergency Medicine, Massachusetts General Hospital

David FM Brown, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

References

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Rhythm strip showing asystole.
Rhythm strip showing ventricular fibrillation.
 
 
 
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