Team, Zach Lavender here from med geeks.

So you're taking sign out for your night shift.

You get settled in, you start to review your patience,

and you get your first page.

Call stat. You pick up the phone, call the extension.

On the other end you hear a frantic nurse saying,

Bed 45, heart rates, 150s, with a regular rhythm on the monitor.

I don't know what to do uh can you come see the patient

my first thought a fit with rvr until proven otherwise so first things first I always

start by telling the nurse, if they're freaking out, like this

case, to take a big deep breath. Then I always run through a quick set of questions with the

nurse with any tacky arrhythmia.

1. Is the patient awake and alert?

A. K. has the tacky arrhythmia caused them to lose consciousness,

warranting intubation.

2. What is the patient's current blood pressure and trend?

ACLS guidelines for tachycardia with pulses asks if the patient is stable. Well what does that mean?

One of the definitions of the unstable patient is hypotension, but what number

correlates with hypotension? A systolic less than 90? Well I've had plenty of

patients with tachy arithmias in a systolic blood pressure less than 90 and

I did not proceed to electricity as the guidelines would suggest.

There's a big difference between blood pressure of 60s

...