Dysrhythmias: Stable vs Unstable, Adenosine, WPW, Torsades & Toxin Traps | EM Board Review

Rhythm emergencies tested on every board. Stable vs unstable as the first fork, adenosine dosing sequence, atrial fibrillation management, WPW with pre-excited AF (and why AV nodal blockers kill), VT management, torsades and magnesium, bradycardia and AV blocks, cardioversion energies, and toxin-driven rhythm traps. 📑 Chapters 0:00 Intro 0:03 Title 0:20 Objectives 0:58 ED Mindset Rhythm Is a Symptom 1:20 Stable vs Unstable The First Fork 1:46 Narrow Complex Tachycardia pre regen 3:03 SVT Vagal Maneuvers & Adenosine 4:17 Atrial Fibrillation in the ED 5:30 AFib Rate Rhythm & Anticoagulation 6:52 WPW & Pre excited AFib 7:47 WPW & Pre excited AFib pre splice 8:43 Wide Complex Tachycardia 9:46 VT vs SVT with Aberrancy 10:59 Torsades de Pointes 12:16 Bradycardia Algorithm 13:33 AV Blocks & When to Pace 14:53 Pacemaker Issues in the ED 15:31 Electrolyte & Toxin Rhythm Traps 16:27 Cardioversion vs Defibrillation Energies 17:08 Board Traps Dysrhythmias 17:53 Case 1 Irregular Wide Tachycardia in WPW 18:28 Case 2 Torsades from QT Prolongation 18:56 Board Question 1 19:14 Board Question 2 19:36 Board Question 3 19:57 Final Takeaways 20:37 References Presented by Ezekiel Shepard, M.D. Shepard EM Board Review — high-yield emergency medicine education for board exams, shift performance, and clinical reasoning. ⏱ CHAPTERS 0:00 Title 0:17 Objectives 0:55 ED Mindset Rhythm Is a Symptom 1:19 Stable vs Unstable The First Fork 1:47 Narrow Complex Tachycardia 2:22 SVT Vagal Maneuvers and Adenosine 3:06 Atrial Fibrillation in the ED 3:45 AFib Rate Rhythm and Anticoagulation 4:40 WPW and Pre excited AFib 5:21 Wide Complex Tachycardia 5:58 VT vs SVT with Aberrancy 6:41 Torsades de Pointes 7:24 Bradycardia Algorithm 8:09 AV Blocks and When to Pace 8:55 Pacemaker Issues in the ED 9:35 Electrolyte and Toxin Rhythm Traps 10:25 Cardioversion vs Defibrillation Energies 11:08 Board Traps Dysrhythmias 11:40 Case 1 Irregular Wide Tachycardia in WPW 12:14 Case 2 Torsades from QT Prolongation 12:44 Board Question 1 13:03 Board Question 2 13:26 Board Question 3 13:50 Final Takeaways 14:33 References 📚 ABOUT THIS SERIES Shepard EM Board Review delivers polished, board-relevant emergency medicine lectures for residents, attendings, and students preparing for boards or trying to sharpen on-shift clinical reasoning. Each lecture covers a focused high-yield topic with specific dosing anchors, treatment-sequence framing, and the classic board traps. 🎓 REFERENCES & ACKNOWLEDGEMENTS Content informed by Rosen's Emergency Medicine (10th edition), Foundations of EM Board Review, and current society guidelines (ACEP, AHA/ACC, SCCM, IDSA, ATLS, and others as relevant per lecture). ECG images: Life in the Fast Lane (LITFL) ECG Library — litfl.com — used with attribution under educational, non-commercial use. ⚠ DISCLAIMER This content is for educational purposes only. It does not replace clinical judgment, institutional protocols, or specialty consultation. Always follow your local guidelines and consult appropriate specialists. 💬 Comment with topics you want covered next. 👍 Like and subscribe for more high-yield emergency medicine board content. #EmergencyMedicine #BoardReview #MedicalEducation #ShepardEMBoardReview