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Broad Complex Tachycardia: Treat First, Label Later

Broad Complex Tachycardia: Treat First, Label Later

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Show notes: Broad complex tachycardia at 2am: treat first, label later. VT until proven otherwise, and why “he’s talking” isn’t stability.Episode 3 — Broad Complex Tachycardia: Treat First, Label Later

Broad complex tachycardia is one of the most stressful rhythms you’ll see on call — because it feels like a test. On nights, you don’t want a test.

In this episode, we break down the safest on-call mindset for broad complex tachycardia: treat first, label later. We focus on risk asymmetry (why VT is the safest default assumption), what matters more than morphology in the first minutes, and how seniors separate signal from noise on the ECG.


You’ll learn:

  • Why “he’s talking, so he’s stable” is a dangerous phrase

  • How to assess tolerance fast: perfusion, trend, and physiology

  • Decision-critical ECG features: AV dissociation, capture beats, fusion beats

  • Bounded actions that reduce risk: pads on early, escalate early, reassess continuously

  • The junior vs senior thinking shift that prevents catastrophic errors

Educational content only — not a substitute for local guidelines or senior clinical advice. For structured interpretation guides, red flags, and full case walkthroughs, visit the AcuteCast app.

https://acute-cast--jgoncalo7.replit.app

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