WhiteBoard Medicine - Emergency And Critical Care

AutoPEEP is one of the most important—and most commonly missed—problems in mechanically ventilated patients.

In this episode, we break down AutoPEEP and the I:E ratio in a clear, practical way so you can understand how they impact ventilation, gas exchange, and patient outcomes in the ICU and emergency department.

We cover:

• What AutoPEEP is and why it occurs

• How the I:E ratio contributes to breath stacking

• The relationshi...

Volume control or pressure control—how do you actually choose the right ventilator mode in real clinical practice?

In this episode, we break down volume control and pressure control ventilation step-by-step, focusing on settings, scalars, and how to apply both modes at the bedside in the ICU and emergency department.

We cover:

• What you set vs what is guaranteed in volume vs pressure control

• Key ventilator settings including...

West zones of the lung are fundamental to understanding how ventilation and perfusion interact in both normal physiology and critical illness.

In this episode, we break down the West zones (Zone 1, Zone 2, and Zone 3) in a simple, clinically relevant way so you can understand how blood flow is distributed throughout the lung—and why it matters at the bedside.

We cover:

• The physiology behind the West zones of the lung

• How al...

Arterial blood gas (ABG) or venous blood gas (VBG)—what’s the difference, and when should you actually use each?

In this episode, we walk through a complete breakdown of ABG and VBG, followed by a direct clinical comparison so you can confidently decide which test to use at the bedside.

We cover:

• What an ABG measures and how to interpret it

• What a VBG tells you and how it differs

• Key differences in pH, CO₂, lactate, and o...

Cardiac output is one of the most important—and most misunderstood—concepts in critical care.

In this episode, we break down cardiac output from first principles and connect it directly to cardiogenic shock, so you can understand not just the numbers—but how to apply them at the bedside.

We cover:

• The cardiac output equation (CO = HR × SV) and what it actually means

• How preload, contractility, and afterload determine stroke...

The I:E ratio is one of the most important—and most misunderstood—settings in mechanical ventilation.

In this episode, we break down the inspiratory-to-expiratory (I:E) ratio in a simple, practical way so you can understand how it impacts ventilation, gas exchange, and patient outcomes in the ICU and emergency department.

We cover:

• What the I:E ratio actually represents

• How it affects airflow, CO₂ clearance, and oxygenation

  ...

Arterial blood gas (ABG) or venous blood gas (VBG)—which should you actually use in clinical practice?

In this episode, we break down the key differences between ABG and VBG in a clear, practical way so you can understand when each test is appropriate in emergency and critical care settings. While ABGs are often considered the gold standard, VBGs can provide clinically useful information in many situations—with less risk and greate...

In this episode, we break down mechanical ventilation from start to finish—designed specifically for your first week in the ICU.

Mechanical ventilation can feel overwhelming early on, with multiple settings, modes, alarms, and physiologic concepts all happening at once. In this episode, we walk through a structured, bedside-relevant framework to help you understand what actually matters when managing ventilated patients.

We cover: ...

Respiratory failure is one of the most common and high-stakes problems in emergency and critical care medicine — but understanding the different types can be confusing.

In this episode, we break down Type 1–4 respiratory failure into a simple, structured framework you can actually use at the bedside. We focus on the key distinction between hypoxemic vs hypercapnic respiratory failure, how to interpret ABGs, and how to recognize the...

Mechanical ventilation is a core skill in critical care and emergency medicine—but the ventilator can feel overwhelming when you’re first learning it.

In this episode, we break down the essential ventilator settings—PEEP, FiO₂, respiratory rate (RR), and tidal volume (TV)—in a way that’s simple, practical, and directly applicable at the bedside.

We focus on building a clear mental model of how the ventilator works, including:

• ...

Understanding stressed vs unstressed volume is one of the most important—and most misunderstood—concepts in hemodynamics and shock.

In this episode, we break down how venous capacitance, mean systemic filling pressure (MSFP), and venous returnactually work, and why they matter for managing critically ill patients in the ICU and emergency department.

We focus on translating physiology into practical bedside understanding, including:

In this episode, we break down non-invasive fluid assessment at the bedside, focusing on IVC ultrasound, VExUS (Venous Excess Ultrasound Score), and the passive leg raise (PLR).

We walk through how to evaluate fluid responsiveness vs fluid tolerance, when each tool works (and when it fails), and how to integrate these approaches into a practical, physiology-based framework for critically ill patients.

This episode tackles one of th...

In this episode, we break down ventilator-induced lung injury (VILI) and how mechanical ventilation can contribute to lung damage in critically ill patients.

We walk through the core mechanisms of VILI—including volutrauma, barotrauma, atelectrauma, and biotrauma—and then build a deeper understanding using the concepts of driving pressure and mechanical power. These frameworks help connect individual ventilator settings to the tota...

In this episode, we break down sickle cell crisis and life-threatening complications, including vaso-occlusive crisis (VOC), acute chest syndrome (ACS), splenic sequestration, aplastic crisis, and infection.

We walk through the underlying pathophysiology of sickle cell disease, why these emergencies occur, and how to recognize and manage them in the emergency department and ICU. This is a high-yield, practical framework to help you...

In this episode, we break down how to assess fluid status at the bedside using IVC ultrasound and VExUS (Venous Excess Ultrasound Score).

We walk through how to interpret IVC diameter and collapsibility, when it works (and when it doesn’t), and how VExUS expands your assessment by integrating hepatic vein, portal vein, and renal venous Doppler to evaluate venous congestion and fluid tolerance.

This episode focuses on one of the mos...

In this episode, we break down mechanical power in mechanical ventilation and its role in ventilator-induced lung injury (VILI).

We walk through how ventilator settings—including tidal volume, respiratory rate, PEEP, and driving pressure—combine to deliver energy to the lungs, and why thinking in terms of total energy delivery may be key to preventing lung injury in critically ill patients.

Rather than focusing on individual ventil...

TEG and ROTEM (viscoelastic testing) can fundamentally change how we approach coagulation — but only if we understand how to interpret them and act on the results.

In this episode, we break down viscoelastic testing from the ground up, then walk step-by-step through how to choose the right blood product based on real physiology — not guesswork.

We cover:

• What TEG & ROTEM actually measure
• How to interpret key parameters (R ...

Vasopressin is often thought of as just a “second-line pressor” — but its physiology and clinical applications are far more nuanced.

In this episode, we break down vasopressin from the ground up, starting with receptor-level physiology and how it differs from catecholamines, then build into a focused deep dive on one of its most important uses: right ventricular (RV) failure and pulmonary hypertension.

We cover:

• V1, V2, and V3...

In this episode, we break down VExUS ultrasound (Venous Excess Ultrasound Score) and how to assess venous congestion at the bedside in critically ill patients.

We walk through the physiology of venous congestion and how to integrate IVC ultrasound, hepatic vein Doppler, portal vein Doppler, and renal venous Doppler into a practical framework for evaluating fluid tolerance vs fluid overload. This is a powerful tool for clinicians ma...