Jordan Matthew R., Lopez Richard A., Morrisonponce Daphne, Flynn Lynnette
Geisinger Medical Center
Arkansas Heart Hospital
Asystole, colloquially referred to as flatline, represents the cessation of electrical and mechanical activity of the heart. Asystole typically occurs as a deterioration of the initial non-perfusing ventricular rhythms: ventricular fibrillation (V-fib) or pulseless ventricular tachycardia (V-tach). Additionally, pulseless electrical activity (PEA) can cease and become asystole. 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).[1][2][3] Asystole represents the terminal rhythm of a cardiac arrest. 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. 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.[4]
心搏停止，通俗地称为平线，代表心脏电活动和机械活动的停止。心搏停止通常是初始无灌注性室性心律恶化的结果：心室颤动（室颤）或无脉性室性心动过速（室速）。此外，无脉电活动（PEA）也可能停止并转变为心搏停止。以心搏停止作为初始心律的心脏骤停受害者预后极差（10%存活至入院，0至2%存活至出院）。[1][2][3]心搏停止代表心脏骤停的终末心律。在院外心脏骤停中，对表现为心搏停止的患者进行长时间复苏不太可能带来医疗益处。根据当地协议允许，应与在线医疗指导协商，考虑对这些患者终止复苏努力。美国急诊医师学会（ACEP）和美国急诊医疗服务医师协会（NAEMSP）均推荐急诊医疗服务系统，并制定了相关协议，允许急诊医疗服务提供者对特定患者群体终止复苏努力，因为对这些患者采取进一步复苏措施并转运至当地急诊科被认为是徒劳的。[4]
