I am having the exact same issue, it started maybe 2-3 days ago. I had been playing for a few hours then all of a sudden it crash, and started crashing every single time I started killing anything. I restarted, reinstalled video card drivers and just about everything else, its starting to look like a fallout problem and not a computer problem.
Are you using mods? What happens if you start a new game?
You can try reverting to a backup save (either quicksave or autosave will do)
Look in C:\Users\
\Documents\My Games\FalloutNV\Saves
Simply rename quicksave.fos.bak by deleting the .bak portion. You'll have to move the original.
Works the same way with autosave.fos.bak