WhiteBoard Medicine - Emergency And Critical Care

Refractory hypoxemia that does not improve with supplemental oxygen should immediately raise concern for a right-to-left shunt. In this ED and ICU case review, we walk through a patient with acute pulmonary embolism causing severe hypoxemia due to intracardiac shunting, reviewing the underlying physiology, diagnostic approach, and management considerations.
We break down: • Mechanisms of refractory hypoxemia • Pulmonary embolism physiology and RV failure • Right-to-left shunt (including PFO physiology) • Why oxygen and ventilation may fail • ED and ICU diagnostic pearls • Management considerations in critically ill patients
 
Link to video: https://www.youtube.com/watch?v=Qey9aRZRGk0 
 
📚 DOWNLOAD PDF FOR THIS VIDEO AT LINK BELOW https://www.patreon.com/c/WhiteBoardMedicine We also have MINI COURSES, STUDY GUIDES, PRACTICE QUESTIONS, AD FREE VIDEOS, EDUCATIONAL DISCUSSIONS in our WBM Emergency Critical Care
Disclaimer: This content is for educational purposes only and does not constitute medical advice. Clinical decisions should be made by licensed healthcare professionals using their clinical judgment, institutional protocols, and current evidence. Whiteboard Medicine assumes no responsibility for clinical outcomes.

Mechanical ventilation saves lives — but small ventilator mistakes can cause major patient harm.
In this episode, we break down 8 common ventilator mistakes that clinicians frequently make in the ICU and emergency department, and explain why they matter physiologically. We cover errors related to tidal volume, PEEP, oxygenation vs ventilation, respiratory rate, patient–ventilator dyssynchrony, hemodynamics, and more — all through a clinically practical, physiology-focused lens.
📌 Topics include: Lung-protective ventilation mistakes Over-oxygenation and oxygen toxicity Mismanagement of PEEP and compliance Ventilator settings that worsen hemodynamics Missed patient–ventilator dyssynchrony Common ICU and ED ventilator pitfalls
Link to video version: https://www.youtube.com/watch?v=PG3ofKVttbY
📚 DOWNLOAD MINI COURSES, STUDY GUIDES, PRACTICE QUESTIONS, AD FREE VIDEOS, EDUCATIONAL DISCUSSIONS in our WBM Emergency Critical Care Patreon Community - Join Today!! https://www.patreon.com/c/WhiteBoardMedicine
DISCLAIMER THIS PODCAST DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, audio, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read, watched, or listened to on this video, or any other videos, reports, texts tweets or other sources.

Positive end-expiratory pressure (PEEP) is one of the most powerful — and misunderstood — tools in mechanical ventilation. In this episode, we break down how PEEP works, why it improves oxygenation, and when it can actually harm patients.
We’ll walk through: • How PEEP recruits alveoli and improves oxygenation • The relationship between PEEP, lung compliance, and overdistension • How excessive PEEP affects venous return, cardiac output, and blood pressure • The concept of optimal PEEP and how to think about titration at the bedside • Common mistakes clinicians make when setting PEEP
📚 DOWNLOAD MINI COURSES, STUDY GUIDES, PRACTICE QUESTIONS, AD FREE VIDEOS, EDUCATIONAL DISCUSSIONS in our WBM Emergency Critical Care Patreon Community - Join Today!! https://www.patreon.com/c/WhiteBoardMedicine
Link to this video: https://www.youtube.com/watch?v=SYdB1ciFNgs
DISCLAIMER THIS PODCAST DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, audio, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read, watched, or listened to on this video, or any other videos, reports, texts tweets or other sources.

Occult cardiogenic shock is one of the most commonly missed shock states in Emergency Medicine and Critical Care. These patients may appear “stable” — with near-normal blood pressure — yet have severe cardiac dysfunction, low cardiac output, and poor tissue perfusion.
In this episode, we break down: 🔹 What occult cardiogenic shock actually is 🔹 Why blood pressure alone is misleading 🔹 The underlying physiology of low cardiac output shock 🔹 How to recognize occult cardiogenic shock at the bedside 🔹 The role of bedside ultrasound, lactate, ScvO₂, and clinical clues 🔹 Practical management principles in the ED and ICU
📚 MINI COURSES, STUDY GUIDES (for this video), PRACTICE QUESTIONS, AD FREE VIDEOS, EDUCATIONAL DISCUSSIONS in our WBM Emergency Critical Care Patreon Community - Join Today!! https://www.patreon.com/c/WhiteBoardMedicine
Playlist on Shock: https://youtube.com/playlist?list=PLf5bMa9_tvRjunk4I-rQZYPZn3qHqWFqW&si=kserFPPm7RYuhul-
DISCLAIMER THIS PODCAST DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, audio, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read, watched, or listened to on this video, or any other videos, reports, texts tweets or other sources.

Shock is a life-threatening condition encountered daily in Emergency Medicine, Critical Care, and the ICU — yet it’s often taught in fragmented algorithms rather than unified physiology.
In this episode, we break down all major shock states in a clear, structured way:
🔹 Hypovolemic shock
🔹 Cardiogenic shock
🔹 Obstructive shock
🔹 Distributive shock (septic, anaphylactic, neurogenic)
📚 MINI COURSES, STUDY GUIDES (for this video), PRACTICE QUESTIONS, AD FREE VIDEOS, EDUCATIONAL DISCUSSIONS in our WBM Emergency Critical Care Patreon Community - Join Today!! https://www.patreon.com/c/WhiteBoardMedicine
Playlist on Shock: https://youtube.com/playlist?list=PLf5bMa9_tvRjunk4I-rQZYPZn3qHqWFqW&si=kserFPPm7RYuhul-
DISCLAIMER THIS PODCAST DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, audio, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read, watched, or listened to on this video, or any other videos, reports, texts tweets or other sources.

This episode is a comprehensive, high-yield guide to ICU basics, designed for medical students, nurses, APCs, interns, residents, emergency medicine physicians, intensivists, and critical care trainees.
We walk step-by-step through the core foundations of ICU care, focusing on physiology-driven decision-making and practical bedside management. Topics include mechanical ventilation, shock, vasopressors and inotropes, and renal replacement therapy—all explained in a clear, clinically relevant framework.
This episode is intended as a big-picture ICU overview and pairs well with deeper dives on each topic. Whether you’re starting ICU rotations or refining your critical care fundamentals, this guide will help build a strong mental model of ICU physiology and management.
📚 DOWNLOAD MINI COURSES, STUDY GUIDES, PRACTICE QUESTIONS, AD FREE VIDEOS, EDUCATIONAL DISCUSSIONS in our WBM Emergency Critical Care Patreon Community - Join Today!! https://www.patreon.com/c/WhiteBoardMedicine
DISCLAIMER THIS PODCAST DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, audio, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read, watched, or listened to on this video, or any other videos, reports, texts tweets or other sources.

Hypovolemic shock is a life-threatening condition caused by a critical reduction in intravascular volume, leading to decreased preload, reduced cardiac output, and impaired tissue perfusion. One of the most severe and common forms is hemorrhagic shock.
In this episode, we begin with a high-yield overview of hypovolemic shock, reviewing core physiology, compensatory mechanisms, hemodynamic patterns, and bedside differentiation from other shock states.
We then transition into a deep dive on hemorrhagic shock, including causes such as trauma and gastrointestinal bleeding, classic clinical presentation, laboratory and point-of-care findings, and the pathophysiologic cascade leading to the lethal triad of acidosis, hypothermia, and coagulopathy.
Management strategies are discussed in detail, including early hemorrhage control, massive transfusion protocols, balanced blood product resuscitation, permissive hypotension, tranexamic acid, calcium replacement, and key ATLS principles. Landmark trials including CRASH-2 and PROPPR are incorporated to support evidence-based care.
📚 MINI COURSES, STUDY GUIDES (for this video), PRACTICE QUESTIONS, AD FREE VIDEOS, EDUCATIONAL DISCUSSIONS in our WBM Emergency Critical Care Patreon Community - Join Today!!
https://www.patreon.com/c/WhiteBoardMedicine
Playlist on Shock: https://youtube.com/playlist?list=PLf5bMa9_tvRjunk4I-rQZYPZn3qHqWFqW&si=kserFPPm7RYuhul-
DISCLAIMER THIS PODCAST DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, audio, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read, watched, or listened to on this video, or any other videos, reports, texts tweets or other sources.

Understanding oxygen content is essential to interpreting pulse oximetry, arterial blood gases, and tissue oxygen delivery. In this video, we walk step-by-step through capillary gas exchange, oxygen content, hemoglobin physiology, and the oxyhemoglobin dissociation curve, tying physiology directly to clinical practice.
📚 MINI COURSES, STUDY GUIDES, PRACTICE QUESTIONS, AD FREE VIDEOS, EDUCATIONAL DISCUSSIONS in our WBM Emergency Critical Care Patreon Community - Join Today!! https://www.patreon.com/c/WhiteBoardMedicine
DISCLAIMER THIS PODCAST DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, audio, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read, watched, or listened to on this video, or any other videos, reports, texts tweets or other sources.

Mechanical ventilation doesn’t have to feel overwhelming. In this episode, we break down mechanical ventilation from the big-picture perspective, focusing on how all the pieces fit together rather than memorizing isolated settings.
We cover the core concepts that actually matter at the bedside, including: • How mechanical ventilation works • Common ventilator modes (AC, PC, APRV, pressure support) • FiO₂, PEEP, and oxygenation strategies • Lung-protective ventilation • Basic ventilator waveforms • Patient–ventilator interaction • Weaning and liberation principles • Common mistakes and misconceptions
📚 DOWNLOAD MINI COURSES, STUDY GUIDES, PRACTICE QUESTIONS, AD FREE VIDEOS, EDUCATIONAL DISCUSSIONS in our WBM Emergency Critical Care Patreon Community - Join Today!! https://www.patreon.com/c/WhiteBoardMedicine
DISCLAIMER THIS PODCAST DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, audio, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read, watched, or listened to on this video, or any other videos, reports, texts tweets or other sources.

Heart failure and cardiogenic shock exist on the same disease spectrum, yet they’re often taught separately. In this episode, we bring them together into a single, cohesive framework that explains how heart failure progresses to cardiogenic shock — and how to manage both at the bedside.
Topics covered include: • Heart failure pathophysiology (HFrEF vs HFpEF) • Preload, afterload, contractility, and cardiac output • Compensated vs decompensated heart failure • Acute decompensated heart failure • Cardiogenic shock physiology • Clinical findings and hemodynamics • Diagnostic approach (exam, labs, echo, ultrasound) • Management principles and common pitfalls
📚 MINI COURSES, STUDY GUIDES (for this video), PRACTICE QUESTIONS, AD FREE VIDEOS, EDUCATIONAL DISCUSSIONS in our WBM Emergency Critical Care Patreon Community - Join Today!! https://www.patreon.com/c/WhiteBoardMedicine
DISCLAIMER THIS PODCAST DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, audio, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read, watched, or listened to on this video, or any other videos, reports, texts tweets or other sources.