All right, so welcome back to the internet book of critical care podcast.

I'm here with Adam Thomas and we're going to talk about reticular tachycardia storm.

So we already hit you up with that torsade point or polymorphic VT.

That was a prolonged QT.

Now we're going to have a normal QT and as Josh said,

that'll be the non-torzad VTVF. This one's a fun presentation to treat, isn't it, Josh?

It's pretty scary and it's relatively rare, but it's super important to be aware of. And I think this

is one of those things that a lot of people are totally unaware of because it doesn't happen a whole lot. So we'll cover what is VT storm, the pathophysiology around that, common causes how to treat it,

and then nuances around intubation and sedation, arterial lines and pressers, anti-arhythmics,

and a awesome, cool new approach to this management that I didn't know about, the cool

stellate ganglion block.

So Josh, start it off.

What is a VT or VF storm?

So ventricular tachycardia or ventricular fibrillation storm, there's, you know, various

definitions floating around there.

I think most people

would agree that this is three or more episodes of VT or VF within a 24-hour period. And some folks would

also call two episodes of VT or VF right after one another to potentially be a storm. So I would think

about this anytime someone has a VTVF and then, you know, you shock them out of it and then like

10 or 15 minutes later they go back into it or a couple hours later they go back into it.

They're kind of just like not staying out of BTVF.

And the way I've seen this before, Josh and how you painted in the post is two kind of phenotypes.

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