WhiteBoard Medicine - Emergency And Critical Care

#248 Viscoelastic Testing Explained | TEG and ROTEM Made Simple (ICU Guide)

Viscoelastic testing with TEG (thromboelastography) and ROTEM (rotational thromboelastometry) is changing how we approach coagulopathy, bleeding, and massive transfusion in the ICU and trauma setting.
In this episode, we break down TEG and ROTEM in a simple, practical way so you can confidently interpret results and apply them at the bedside.
We cover:
The fundamentals of viscoelastic testing physiology
Key TEG parameters: R time, K time, alpha angle, MA, LY30
ROTEM equivalents and how they compare
EXTEM, INTEM, FIBTEM, APTEM
How to recognize patterns of coagulopathy (platelet dysfunction, fibrinogen deficiency, hyperfibrinolysis)
Using TEG/ROTEM to guide massive transfusion protocols (MTP)
Practical applications in trauma, surgery, and critical care
This episode is part of our emergency critical care series focused on making complex ICU physiology and decision-making simple, visual, and clinically actionable.
🔥 Master emergency critical care with our full curriculum + downloadable study guides:https://www.patreon.com/c/WhiteBoardMedicine
Study guides • Mini-courses • Practice questions • Structured ICU curriculum • Ad-free episodes
📺 Watch the full video version here:https://www.youtube.com/watch?v=LbxDwh7jQlo
⚠️ Disclaimer:This podcast is for educational purposes only and does not constitute medical advice. The views expressed are those of the creators and do not represent any affiliated institutions. Clinical decisions should be made based on individual patient context, current evidence, and institutional protocols.

#247 ICU Stress Ulcer Prophylaxis Explained | Indications, Medications, Pros, Cons, & Evidence

Stress ulcer prophylaxis is one of the most common interventions in the ICU — but also one of the most overused and misunderstood.
In this episode, we break down when stress ulcer prophylaxis is actually indicated, what medications to use, and what the evidence really shows so you can make better bedside decisions.
We cover:
The pathophysiology of stress-related mucosal disease (SRMD) and GI bleeding
Which ICU patients are truly high risk (shock, coagulopathy, critical illness)
Evidence-based indications for prophylaxis vs overuse
PPIs vs H2 blockers — mechanisms, benefits, and risks
Potential harms including pneumonia, C. difficile, and unnecessary continuation
When to start and stop therapy based on ICU course and risk factors
Current evidence suggests stress ulcer prophylaxis should be targeted to high-risk patients rather than applied universally, with discontinuation once risk factors resolve.
This episode is part of our emergency critical care series focused on making ICU pharmacology and physiology simple, practical, and clinically applicable.
🔥 Master emergency critical care with our full curriculum + downloadable study guides:https://www.patreon.com/c/WhiteBoardMedicine
Study guides • Mini-courses • Practice questions • Structured ICU curriculum • Ad-free episodes
📺 Watch the full video version here:https://www.youtube.com/watch?v=PPBoXHIPKnE
⚠️ Disclaimer:This podcast is for educational purposes only and does not constitute medical advice. The views expressed are those of the creators and do not represent any affiliated institutions. Clinical decisions should be made based on individual patient context, current evidence, and institutional protocols.

#246 Vasopressin in Right Ventricular Failure | When & Why It Works (ICU Guide)

Vasopressin plays a unique and often underutilized role in the management of right ventricular (RV) failure, particularly in patients with pulmonary hypertension, massive pulmonary embolism, and RV shock.
In this episode, we break down why vasopressin works differently from other vasopressors, how it affects pulmonary vs systemic vascular resistance, and when it may be the preferred agent in right heart dysfunction.
We cover:
The physiology of right ventricular failure and afterload sensitivity
Why traditional vasopressors may worsen RV function
The mechanism of vasopressin in pulmonary circulation
Clinical scenarios where vasopressin is most useful
A practical framework for vasopressor selection in RV shock
This episode is part of our broader emergency critical care series focused on making complex ICU physiology simple, practical, and clinically applicable.
🔥 Master emergency critical care with our full curriculum + downloadable study guides:https://www.patreon.com/c/WhiteBoardMedicine
Study guides • Mini-courses • Practice questions • Structured ICU curriculum • Ad-free episodes
📺 Watch the full video version here:https://www.youtube.com/watch?v=_6vpXlsAu_Y
⚠️ Disclaimer:This podcast is for educational purposes only and does not constitute medical advice. The views expressed are those of the creators and do not represent any affiliated institutions. Clinical decisions should be made based on individual patient context, current evidence, and institutional protocols.

#245 ICU Pharmacology Explained | Sedation, Vasopressors & Fluids Made Simple

ICU pharmacology can feel overwhelming—sedation, vasopressors, fluids, and dozens of medications interacting in critically ill patients.
In this episode, we break down ICU pharmacology into three foundational domains that form the backbone of bedside critical care:
Sedation and analgesia (propofol, fentanyl, dexmedetomidine)
Vasopressors and inotropes (norepinephrine, vasopressin, epinephrine, dopamine, dobutamine)
Intravenous fluids (crystalloids, colloids, and fluid resuscitation strategies in shock)
This is not a comprehensive review of all ICU medications, but a practical, physiology-driven framework to help you understand how these therapies work together in real patients.
We focus on hemodynamics, perfusion, sedation strategies, and fluid management—with an emphasis on septic shock, respiratory failure, and emergency critical care applications.
🎥 Watch the full video version here:https://www.youtube.com/watch?v=bjvdOucsAQY
📚 Want to go deeper? Full ICU curriculum + study guides:• Downloadable PDF study guides• Mini-courses on shock, ventilation, and critical care• Practice questions for boards and bedside learning• Structured emergency critical care curriculum• Ad-free content
👉 https://www.patreon.com/c/WhiteBoardMedicine
👩‍⚕️ Who this episode is for:Medical students, residents, fellows, nurses, respiratory therapists, and practicing clinicians in emergency medicine and critical care.
⚠️ Podcast Disclaimer:This podcast is for educational purposes only and is not intended to provide medical advice. The views expressed are those of the hosts and do not represent any affiliated institutions. Clinical decisions should always be made based on individual patient circumstances, current evidence, and institutional protocols.

#244 Arterial Line Waveform Explained: Placement, Normal Waveform & Pulse Pressure Variation

In this episode of Whiteboard Medicine, we break down the fundamentals of arterial line monitoring and how to interpret the arterial pressure waveform at the bedside.
Arterial lines are one of the most powerful tools for managing critically ill patients in the ICU, emergency department, and operating room, but accurate interpretation requires understanding the underlying hemodynamic physiology. In this episode we walk through how arterial lines are placed, the key components of the normal arterial waveform, and how clinicians can use pulse pressure variation (PPV) to assess fluid responsiveness in mechanically ventilated patients.
Whether you are managing shock, titrating vasopressors, or evaluating hemodynamic instability, understanding arterial waveform physiology is essential for bedside decision making in critical care.
Topics covered in this episode include:
• Fundamentals of arterial line placement• Components of the normal arterial waveform• Systolic upstroke, dicrotic notch, and diastolic runoff• Causes of abnormal arterial waveforms• Pulse pressure variation (PPV) explained• Using PPV to assess fluid responsiveness• Practical bedside interpretation for ICU clinicians
Watch the full video version of this episode here:https://www.youtube.com/watch?v=jocAWm7RPig
📚 Download the PDF study guide for this video:👉 https://www.patreon.com/c/WhiteBoardMedicine
Patreon members get access to mini-courses, study guides, practice questions, ad-free videos, and in-depth educational discussions designed for emergency and critical care clinicians.
Disclaimer:Whiteboard Medicine content is for educational purposes only and is intended for healthcare professionals and trainees. This content should not be considered medical advice and should not replace clinical judgment, institutional protocols, or consultation with qualified medical professionals.

#243 Everything You Need to Know About CRRT | CVVH, CVVHD, CVVHDF A Complete ICU Guide

Continuous Renal Replacement Therapy (CRRT) is one of the most important dialysis therapies used in the ICU for critically ill patients with acute kidney injury (AKI), septic shock, metabolic acidosis, and fluid overload.
In this complete ICU guide, we cover everything you need to know about CRRT, including:
• CRRT basics and core physiology• Indications for CRRT in the ICU• CRRT prescription fundamentals• Effluent dose (20–25 mL/kg/hr)• Ultrafiltration and net fluid removal• Dialysate vs replacement fluid• Transmembrane pressure and sieving coefficient• CVVH (convection-based CRRT)• CVVHD (diffusion-based CRRT)• CVVHDF (combined diffusion + convection)• Full modality comparison• CRRT vs intermittent hemodialysis (iHD)• CRRT vs SLED• When to choose each therapy
Core framework:
CVVH = convection (flow-driven clearance)CVVHD = diffusion (gradient-driven clearance)CVVHDF = both
CRRT = continuous, hemodynamically gentle dialysis ideal for unstable ICU patients.
If you work in emergency medicine, critical care, nephrology, or the ICU, this episode provides a clear and practical framework for understanding and prescribing continuous renal replacement therapy.
Designed for ICU nurses, residents, fellows, respiratory therapists, advanced practice clinicians, and physicians.
Master the mechanism — not just the machine settings.
📚 Download the PDF study guide for this video:👉 https://www.patreon.com/c/WhiteBoardMedicine
Patreon members get access to mini-courses, study guides, practice questions, ad-free videos, and in-depth educational discussions designed for emergency and critical care clinicians.
Watch the full video version:https://www.youtube.com/@WhiteBoardMedicine
Disclaimer:This podcast is for educational purposes only and is not intended to provide medical advice, diagnosis, or treatment. The information discussed reflects general principles of emergency and critical care medicine and should not replace clinical judgment, institutional protocols, or individualized patient care decisions. Always consult appropriate medical professionals and guidelines when managing patients.

#242 CRRT Masterclass: Complete Guide to CVVH, CVVHD & CVVHDF + Full Comparison

Continuous Renal Replacement Therapy (CRRT) is one of the most important dialysis therapies in critical care and the ICU — yet many clinicians struggle to understand the differences between CVVH, CVVHD, and CVVHDF.
In this CRRT Masterclass, we provide a complete guide to:
• CVVH (convection-based CRRT)• CVVHD (diffusion-based CRRT)• CVVHDF (combined diffusion + convection)• CRRT physiology and mechanisms• CRRT prescription and dosing (20–25 mL/kg/hr)• Ultrafiltration and fluid removal• Dialysate vs replacement fluid• Effluent rate and clearance• Small vs middle molecule removal• Full comparison of CRRT modalities• CRRT vs intermittent hemodialysis (iHD)• CRRT vs SLED
We also explain when to choose each CRRT modality in patients with:
• Acute kidney injury (AKI)• Septic shock• Severe metabolic acidosis• Hyperkalemia• Multi-organ failure• Volume overload in the ICU
If you work in emergency medicine, critical care, nephrology, or the ICU, this episode will give you a clear and practical framework for prescribing and managing continuous dialysis at the bedside.
Designed for ICU nurses, residents, fellows, respiratory therapists, advanced practice clinicians, and physicians.
Master the mechanism — not just the machine settings.
📚 Download the PDF study guide for this video:👉 https://www.patreon.com/c/WhiteBoardMedicine
Patreon members get access to mini-courses, study guides, practice questions, ad-free videos, and in-depth educational discussions designed for emergency and critical care clinicians.
Watch the full video version:https://www.youtube.com/@WhiteBoardMedicine
Disclaimer:This podcast is for educational purposes only and is not intended to provide medical advice, diagnosis, or treatment. The information discussed reflects general principles of emergency and critical care medicine and should not replace clinical judgment, institutional protocols, or individualized patient care decisions. Always consult appropriate medical professionals and guidelines when managing patients.

#241 CVVH vs CVVHD vs CVVHDF Explained | CRRT Modalities Comparison for the ICU

Continuous Renal Replacement Therapy (CRRT) can feel confusing — especially when trying to differentiate between CVVH, CVVHD, and CVVHDF. In this episode, we provide a clear, side-by-side comparison of all three modalities so you can understand how each works, when they are used, and how solute and fluid removal differ.
We break down convection vs diffusion, replacement fluid vs dialysate, ultrafiltration control, clearance efficiency, effluent dosing, and practical ICU decision-making. By the end of this episode, you’ll have a structured framework to confidently explain the differences between CVVH, CVVHD, and CVVHDF at the bedside.
This is a high-yield overview designed for emergency physicians, intensivists, residents, nurses, respiratory therapists, and advanced practice clinicians who want CRRT to finally “click.”
🎥 Watch the full YouTube video here:👉https://www.youtube.com/watch?v=FaAlplfPgL0
📚 Download the PDF study guide for this video:👉 https://www.patreon.com/c/WhiteBoardMedicinePatreon members get access to mini-courses, study guides, practice questions, ad-free videos, and in-depth educational discussions designed for emergency and critical care clinicians.
Disclaimer: This podcast is for educational purposes only and is not medical advice. Clinical decisions should always be made based on individual patient circumstances, institutional protocols, and consultation with appropriate specialists.

#240 Continuous Venovenous Hemodialysis CVVHD Explained | ICU CRRT Deep Dive

Continuous Venovenous Hemodialysis (CVVHD) is a core modality of continuous renal replacement therapy (CRRT) — but many clinicians struggle to fully understand how diffusion-based clearance works in the ICU.
In this episode, we break down CVVHD step-by-step, including dialysate flow, solute diffusion, ultrafiltration control, effluent rates, clearance principles, and how CVVHD differs from CVVH and CVVHDF. We focus on practical bedside physiology so you can clearly understand how toxins are removed, how fluid balance is controlled, and how settings impact patient care.
This episode is designed for emergency physicians, intensivists, trainees, nurses, respiratory therapists, and advanced practice clinicians who want a structured, physiology-first framework for CRRT.
If CRRT has ever felt overwhelming, this deep dive will simplify CVVHD into clear, actionable concepts.
🎥 Watch the full YouTube video here:👉https://www.youtube.com/watch?v=ymfP1RxqOuw
📚 Download the PDF study guide for this video:👉 https://www.patreon.com/c/WhiteBoardMedicinePatreon members get access to mini-courses, study guides, practice questions, ad-free videos, and in-depth educational discussions designed for emergency and critical care clinicians.
Disclaimer: This podcast is for educational purposes only and is not medical advice. Clinical decisions should always be made based on individual patient circumstances, institutional protocols, and consultation with appropriate specialists.

#239 Continuous Venovenous Hemodiafiltration CVVHDF Explained | ICU CRRT Deep Dive

Continuous Venovenous Hemodiafiltration (CVVHDF) is one of the most complex — and most misunderstood — modalities of continuous renal replacement therapy (CRRT). In this episode, we break down CVVHDF from the ground up, including diffusion vs convection, dialysate and replacement fluid, solute clearance, ultrafiltration control, and how this modality differs from CVVH and CVVHD.
We walk through ICU-relevant physiology, clinical decision-making, and practical bedside considerations to help emergency physicians, intensivists, residents, nurses, and advanced practice clinicians understand how CVVHDF actually works in critically ill patients.
If CRRT has ever felt confusing, this episode brings it together into one clear framework.
🎥 Watch the full YouTube video here:👉https://www.youtube.com/watch?v=WQ_BdSXdRuc
📚 Download the PDF study guide for this video:👉 https://www.patreon.com/c/WhiteBoardMedicinePatreon members get access to mini-courses, study guides, practice questions, ad-free videos, and in-depth educational discussions designed for emergency and critical care clinicians.
Disclaimer: This podcast is for educational purposes only and is not medical advice. Clinical decisions should always be made based on individual patient circumstances, institutional protocols, and consultation with appropriate specialists.