In “The Thinking Series” Ginger talks with the sharpest minds in emergency medicine about how they think. This time she delves into how an EMS Medical director asks her medics to bend their brains around the topic of tachycardia. Her name is Dr. Katherine Remick and she is triple board certified in Emergency Medicine, EMS and Pediatrics. She is a professor at The University of Texas’ Dell Medical School in Austin but Ginger met up with her at an EMS Station in Hays County Texas where Dr. Remick is the medical director. This is the first episode of Medic Mindset recorded at a station so you are invited to enjoy this episode with occasional sounds of the station in the background.


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Sinus Tachycardia at 194 bpm

 

Show notes:

Dr. Katherine Remick

Differentiation of SVT from Sinus Tachycardia

Importance of curiosity in history taking

Her opinion on the use of mnemonics as memory aids in differential diagnosis

Physiologic max heart rate

Causes of tachycardias are either intrinsic or extrinsic to the heart

Pediatric sinus tachycardia morphology

Visual approach to differential diagnosis: “head-to-toe” and then “in-to-out”

Her list of causes of Sinus Tachycardia

SVT is an umbrella term

Tom Bouthillet and his website ems12lead.com

Undifferentiated tachycardia via ems12lead.com

WPW (Wolff-Parkinson-White)

Dangers of beta-blockers and calcium channel blockers

Hemodynamic stability versus instability

Approach to patient in A. fib with RVR and who is in sepsis


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Cover art by William Sink
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Dr. Katherine Remick

Other resources related to Tachycardia:

FOAMfrat: The Day I Almost Died… From SVT” 

“The Trouble with Sinus Tachycardia” from ems12lead.com


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