Asystole and Its Treatment in ACLS

Asystole is defined as a cardiac arrest rhythm in which there is no discernible electrical

activity on the ECG monitor. Asystole is sometimes referred to as a flat line.
Confirmation that a flat line is truly asystole is an important step in the ACLS protocol.
Ensure that asystole is not another rhythm that looks like a flat line. Fine VF can appear
to be asystole, and a flat line on a monitor can be due to operator error or equipment
failure

The following are common causes of an isoelectric line that is not asystole: 1. loose or
disconnected leads; 2. loss of power to the ECG monitor; 3. low signal gain on the ECG
monitor.

Asystole for many patients is the result of a prolonged illness or cardiac arrest, and
prognosis is very poor. Few patients will likely have a positive outcome and successful
treatment of cardiac arrest with asystole will usually involve identification and correction
of an underlying cause of the asystole.
The Hs and Ts of ACLS should be reviewed to identify any underlying cause that could
have precipitated the asystole.
Some of the most common reasons to stop or withhold resuscitative efforts are:
DNR status
Threat to the safety of rescuers
Family or personal information such as a living will or advanced directive
Rigor mortis
Asystole is treated using the right branch of the puslesless arrest arrest algorithm. Click
below to view the pulseless arrest algorithm diagram. When done click again to close the
diagram.