If pt is tachy/brady; 1. Always check for any associated sx (eg: chest pain, palpitations) 2. Do ECG STAT to rule out acute emergency conditions. 3. Check medications that can cause tachy/brady. 4. Check pt's hydration, temperature. 5. If pt post op - check for any sign of bleed or sepsis. 6. Be careful in dengue pt with tachycardia - as it is sign of compensated.