WhiteBoard Medicine - Emergency And Critical Care

#180 Endocrine Shock Explained: Adrenal Crisis, Myxedema Coma, Thyroid Storm

Endocrine shock refers to life-threatening shock states caused by hormonal deficiencies or endocrine crises that impair vascular tone, cardiac output, and metabolism. Unlike other forms of shock, endocrine shock is often diagnosed only after common causes such as sepsis, cardiogenic, or hypovolemic shock have been ruled out.
In this episode, we break down the pathophysiology, clinical presentation, and hemodynamic patterns of the most important endocrine emergencies: adrenal crisis, myxedema coma, thyroid storm, and severe hypoglycemia. We focus on recognition of key clues such as refractory hypotension, bradycardia, hypothermia, electrolyte abnormalities, and metabolic collapse.
Management principles including IV hydrocortisone for adrenal crisis, thyroid hormone replacement for myxedema coma, beta-blockade and thionamides for thyroid storm, and dextrose for hypoglycemia are reviewed alongside guideline-based recommendations. This video is designed for emergency medicine, critical care, and internal medicine trainees as well as board exam preparation.
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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.

#179 Acute Respiratory Distress Syndrome (ARDS) Advanced - Diagnosis | Clinical Medicine

Acute Respiratory Distress Syndrome (ARDS) diagnosis can be complex, but is critically important. In this video, we dive into the complexities of diagnosing ARDS. We discuss the Berlin Criteria as a diagnostic approach before transitioning into the newer Global Definition of ARDS published in 2024. We compare and contrast these two diagnostic frameworks, review real-world examples, and discuss how to apply this clinically.
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Acute Respiratory Distress Syndrome (ARDS) Playlist! https://youtube.com/playlist?list=PLf5bMa9_tvRjiYBmr3Vo83Jx6IXpwH_U3&si=J-PJQue9lCOgkx4B
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.

#178 Neurogenic Shock Explained: Physiology, Diagnosis, and Management | Trauma & Critical Care

Neurogenic shock is a form of distributive shock caused by loss of sympathetic tone after spinal cord injury, most commonly with lesions above T6. Unlike other shock states, it presents with hypotension, bradycardia, and warm, dry skin.
In this episode, we break down the pathophysiology of neurogenic shock, how to distinguish it from spinal shock, classic clinical findings, and high-yield hemodynamic patterns. We also review evidence-based management including fluid strategy, vasopressor selection, bradycardia treatment, and temperature control.
Guideline-based targets for spinal cord perfusion, including AANS/CNS MAP goals, are discussed along with critical trauma and ICU pearls. This video is designed for emergency medicine, critical care, trauma, and neurology trainees as well as board exam preparation.
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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.

#177 Respiratory Physiology Basics: Minute Ventilation and Alveolar Ventilation | Clinical Medicine

Minute ventilation, alveolar ventilation, and dead space are critical foundational concepts to understanding when working to master respiratory physiology. Learn about these critical topics in this episode!
 
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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.

#176 Cardiogenic Shock Explained: Hemodynamics, Causes, and Management | Emergency Critical Care

Cardiogenic shock is a life-threatening form of shock caused by primary cardiac pump failure, leading to severely reduced cardiac output despite adequate intravascular volume.
In this episode, we break down the physiology of cardiogenic shock, classic clinical presentations, hemodynamic patterns, and evidence-based management strategies. Major causes including acute myocardial infarction, arrhythmias, acute valvular failure, and cardiomyopathies are reviewed, along with practical bedside management pearls.
We also cover mechanical circulatory support options (IABP, Impella, VA-ECMO), vasoactive medications, and landmark trials including the SHOCK Trial, IABP-SHOCK II, and CULPRIT-SHOCK.
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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.

#175 Obstructive Shock Explained: PE, Tamponade, Tension Pneumothorax | Emergency Critical Care

Obstructive shock is a life-threatening form of circulatory failure caused by mechanical obstruction to cardiac filling or outflow, leading to decreased cardiac output and tissue hypoperfusion.
In this episode, we walk through obstructive shock physiology, classic clinical presentations, hemodynamic patterns, and high-yield management strategies for the most important causes: massive pulmonary embolism, cardiac tamponade, and tension pneumothorax.
We also highlight how bedside ultrasound (POCUS) can rapidly differentiate types of obstructive shock and guide definitive, life-saving interventions in the emergency department and ICU.
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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.

#174 Hypovolemic Shock Explained: Physiology, Hemodynamics, and Management

Hypovolemic shock is a life-threatening condition caused by loss of intravascular volume, leading to decreased preload, reduced cardiac output, and impaired tissue perfusion. In this episode, we break down hypovolemic shock from first principles, focusing on physiology, hemodynamics, clinical presentation, and evidence-based management.
Link to YouTube Video: https://www.youtube.com/watch?v=hd4qVaBV_gg
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You’ll learn how hypovolemic shock differs from other shock states, how to recognize it at the bedside, and how to manage hemorrhagic vs non-hemorrhagic causes using fluids, blood products, and source control.
📌 Topics Covered: What hypovolemic shock is (and why it happens) Classic vitals & physical exam findings Hemodynamic profile: preload, CO, SVR, MAP Hemorrhagic vs non-hemorrhagic hypovolemia Fluid resuscitation vs blood transfusion TXA and balanced resuscitation (CRASH-2, PROPPR) High-yield board and bedside pearls
This episode is designed for medical students, residents, fellows, nurses, respiratory therapists, and critical care providers who want a clear, high-yield framework for mastering shock states in real clinical practice.
 
DISCLAIMER THIS PODCAST DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, text, audio, 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.

#173 Distributive Shock Crash Course | Sepsis, Anaphylaxis, Neurogenic Shock

Distributive shock is one of the most important shock states to recognize in emergency and critical care medicine. In this high-yield breakdown, we cover pathophysiology, clinical presentation, hemodynamics, and evidence-based management — including sepsis, anaphylaxis, and neurogenic shock.
You’ll learn: ↓ SVR and “relative hypovolemia” Warm shock vs late cold shock progression Hyperdynamic cardiac output in early sepsis Neurogenic shock and bradycardia When to use fluids vs vasopressors Norepinephrine as first-line pressor When to add vasopressin or steroids Key trials: EGDT, ProCESS, ARISE, ProMISe, VASST, SOAP II, ADRENAL, APROCCHSS.
Management pearls: Fluids + antibiotics early in septic shock IM epinephrine first-line for anaphylaxis Phenylephrine or norepinephrine in neurogenic shock MAP ≥ 65 mmHg, lactate clearance, urine output targets
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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.

#172 Pulmonary Artery Catheters (Swan-Ganz) Explained | Hemodynamics, Indications, Waveforms, Trials

Pulmonary artery catheters (PACs), also known as Swan-Ganz catheters, provide a detailed window into a patient’s hemodynamics.
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In this episode, we cover: What a PAC is and what it measures (RA, RV, PA, PAOP, CO, SvO₂). When to use it: refractory shock, advanced heart failure, pulmonary hypertension, complex perioperative cases. Step-by-step placement and waveform interpretation. Calculations: SVR, PVR, CI, SvO₂ — and how to apply them clinically. Key benefits, limitations, and risks (arrhythmias, PA rupture, over-wedging). Landmark trials: ESCAPE (2005), PAC-Man (2005), Sandham (2003), FACTT (2006). How to integrate PAC data with echocardiography for patient management.
Link to video: https://www.youtube.com/watch?v=h-nlPhZP49U
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.

#171 Spontaneous Breathing Trial SBTs Explained | RSBI, Pressure Support vs T Piece, Extubation Readiness

Spontaneous Breathing Trials (SBTs) are the gold-standard test to determine whether a patient can be safely extubated from mechanical ventilation.
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In this episode, we break down everything you need to know: What SBTs are and why they matter. Prerequisites before starting a trial. The different SBT methods: T-piece, Pressure Support Ventilation (PSV), and CPAP. How to assess patient success with RSBI, vital signs, and clinical markers. Landmark studies, including Esteban et al. (NEJM 1996) and Thille et al. (JAMA 2016). A full review of Tanios et al. (Crit Care Med 2016) evaluating RSBI in modern ICUs.
Link to video: https://www.youtube.com/watch?v=hvipBHX2BAQ
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.