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January 14, 2025 60 mins
Learn a systematic approach to management of wide complex tachycardia that doesn't rely on exact rhythm identification or scoring systems with guest Dr. Kevin Butler. By understanding the physiology rather than memorizing a score or algorithm you can use Kevin's approach and ABCD mnemonic to help differentiate between ventricular tachycardia, SVT with aberrancy, and other arrhythmias. Learn how not to miss the vital mimics with his SPAM filter. And finally by understanding which treatments are safe and which treatments potentially dangerous you can understand how to move forward even when you're not exactly sure what the arrhythmia is. Whether you're an EMT, paramedic, or emergency physician, this episode provides the essential principles and stepwise strategies to ensure effective and safe patient management. 00:00 Introduction to Arrhythmia Management 00:29 Personal Anecdote: Lessons from Paramedic School 02:04 Introducing Dr. Kevin Butler 02:16 Sponsor Message: The Recess Tailor 03:35 Welcome to EMS Cast 04:04 Understanding Wide Complex Tachycardia 05:37 Approach to Arrhythmia Management 07:02 Principles of Managing Wide Complex Tachycardia 08:39 Pathophysiology of Wide Complex Tachycardia 18:30 Identifying and Treating Mimics 26:55 Regular vs. Irregular Wide Complex Tachycardia 29:59 Understanding Torsades and Its Management 30:25 Identifying Atrial Fibrillation with Pre-Excitation 32:14 Treatment Considerations for AFib with WPW 35:02 Distinguishing Between VT and SVT with Aberrancy 37:09 Physiological Approach to ECG Interpretation 40:24 ABCD Mnemonic for VT Diagnosis 47:49 EMS Treatment Protocols for Wide Complex Tachycardia 51:54 Pre-Hospital Cardioversion Tips 55:22 Emergency Department Approach to Wide Complex Tachycardia 58:00 Final Thoughts and Key Takeaways

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Guest/Cast/Crew information- Guest- Dr. Kevin Butler, Emergency Physician, Lead Instructor for DHREM's EKG didactic curriculum Host- Ross Orpet, Will Berry  Catch up with us after the show

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