WhiteBoard Medicine - Emergency And Critical Care

Neuroleptic malignant syndrome (NMS) is a rare but life-threatening toxicologic emergency associated with dopamine blockade and antipsychotic medications. Early recognition is critical in the emergency department, ICU, inpatient wards, and perioperative settings.
In this episode, we review the fundamentals of neuroleptic malignant syndrome including:• Pathophysiology• Dopamine blockade• Common causative medications• Hyperthermia• Muscle rigidity• Elevated CK and rhabdomyolysis• Autonomic instability• Differential diagnosis• Serotonin syndrome vs NMS• ICU and emergency department management• Supportive care strategies• Bromocriptine and dantrolene
This episode is designed for physicians, nurses, pharmacists, trainees, respiratory therapists, and anyone interested in emergency critical care medicine and toxicology.
🎥 YouTube video: https://www.youtube.com/watch?v=di0ksOt1Dl0 
📚 Download the study guide + access our complete emergency critical care curriculum:https://www.patreon.com/c/WhiteBoardMedicine
Our Patreon includes:• PDF study guides for every episode• Emergency critical care mini-courses• Practice questions• Ad-free content• A structured ICU curriculum
🎧 WhiteBoard Medicine Podcast:https://podcasts.apple.com/us/podcast/whiteboard-medicine-emergency-and-critical-care/id1808306430
DISCLAIMER:This content is intended for educational purposes only and should not be considered medical advice. Clinical decisions should always be made using independent medical judgment, current guidelines, institutional protocols, and consultation with appropriate specialists. This content does not establish a physician-patient relationship and may not reflect the views of any affiliated institutions or employers.

Salicylate toxicity is one of the most important acid-base and toxicologic emergencies encountered in emergency medicine, critical care, and hospital medicine. In this episode, we break down salicylate poisoning from the ground up including salicylate pharmacology, acid-base physiology, respiratory alkalosis, metabolic acidosis, sodium bicarbonate therapy, hemodialysis indications, airway management, and ICU management strategies.
We also discuss:• Recognition of salicylate toxicity• Tachypnea and compensatory hyperventilation• Salicylate distribution and tissue penetration• Pulmonary edema and CNS toxicity• Volume depletion and electrolyte abnormalities• Intubation pitfalls in salicylate poisoning• Why mechanical ventilation can rapidly worsen critically ill patients• Co-ingestions and diagnostic challenges
This episode is designed for medical students, residents, fellows, nurses, respiratory therapists, advanced practice providers, and practicing clinicians looking for a high-yield review of salicylate toxicity and acid-base disorders in critical illness.
Watch the full YouTube video here:https://www.youtube.com/watch?v=tcUS6v_Cktc
🔗 Download the full study guide + access our complete emergency critical care curriculum:https://www.patreon.com/c/WhiteBoardMedicine
Our Patreon includes:• Study guides for every video• Mini-courses (ventilation, shock, RRT & more)• Practice questions• Ad-free videos• A structured ICU curriculum
WhiteBoard Medicine Podcast:https://podcasts.apple.com/us/podcast/whiteboard-medicine-emergency-and-critical-care/id1808306430
Disclaimer:WhiteBoard Medicine content is intended for educational purposes only and should not be interpreted as medical advice, diagnosis, or treatment recommendations. Clinical decisions should always be made using independent medical judgment, current guidelines, institutional protocols, and specialist consultation when appropriate.

Opioid toxicity remains one of the most important toxicologic emergencies encountered in emergency medicine, critical care, EMS, and hospital medicine. In this episode, we break down opioid overdose from the ground up including opioid pharmacology, respiratory depression physiology, recognition of the opioid toxidrome, naloxone administration, airway management, ventilator considerations, post-reversal monitoring, and ICU management strategies.
We also discuss:• Hypoventilation and hypercapnia• End tidal CO2 monitoring• Pulmonary edema in opioid overdose• Long-acting opioids and recurrent toxicity• Co-ingestions and diagnostic pitfalls• Intubation considerations in critically ill overdose patients
This episode is designed for medical students, residents, fellows, nurses, respiratory therapists, advanced practice providers, and practicing clinicians looking for a high-yield review of opioid toxicity and overdose management.
Watch the full YouTube video here:https://www.youtube.com/watch?v=aUjvkQq4kJg
🔗 Download the full study guide + access our complete emergency critical care curriculum:https://www.patreon.com/c/WhiteBoardMedicine
Our Patreon includes:• Study guides for every video• Mini-courses (ventilation, shock, RRT & more)• Practice questions• Ad-free videos• A structured ICU curriculum
WhiteBoard Medicine Podcast:https://podcasts.apple.com/us/podcast/whiteboard-medicine-emergency-and-critical-care/id1808306430
Disclaimer:WhiteBoard Medicine content is intended for educational purposes only and should not be interpreted as medical advice, diagnosis, or treatment recommendations. Clinical decisions should always be made using independent medical judgment, current guidelines, institutional protocols, and specialist consultation when appropriate.

The Frank-Starling curve is one of the most important concepts in cardiac physiology—and one of the most clinically useful in critical care.
In this episode, we break down the Frank-Starling relationship and connect it directly to cardiac output, so you can understand how preload affects stroke volume and how this translates to real bedside decision-making.
We cover:
What the Frank-Starling curve represents
How preload affects stroke volume and cardiac output
The relationship between venous return, ventricular stretch, and contractility
How to identify the steep vs plateau portions of the curve
What fluid responsiveness actually means
Clinical applications in shock, heart failure, and critical illness
Whether you’re managing hypotension, shock, or complex hemodynamics, this episode provides a clear framework to understand preload responsiveness and optimize perfusion in real time.
🎥 Watch the full video version here:https://www.youtube.com/watch?v=eEWGl7OGKaM
📚 Download the full study guide + access our complete emergency critical care curriculum:https://www.patreon.com/c/WhiteBoardMedicine
Our Patreon includes:• Study guides for every video• Mini-courses (ventilation, shock, RRT & more)• Practice questions• Ad-free videos• A structured ICU curriculum
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.

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 relationship between expiratory time, airflow, and trapped gas
How to recognize AutoPEEP on ventilator waveforms
How to adjust the I:E ratio to prevent and treat AutoPEEP
Clinical scenarios including COPD, asthma, and ARDS
Whether you’re managing obstructive lung disease or troubleshooting a ventilated patient with rising pressures, this episode gives you a practical framework to recognize and fix AutoPEEP at the bedside.
🎥 Watch the full video version here:https://www.youtube.com/watch?v=5npK_gDbw5g
📚 Download the full study guide + access our complete emergency critical care curriculum:https://www.patreon.com/c/WhiteBoardMedicine
Our Patreon includes:• Study guides for every video• Mini-courses (ventilation, shock, RRT & more)• Practice questions• Ad-free videos• A structured ICU curriculum
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.

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 tidal volume, inspiratory pressure, flow, and PEEP
How to interpret scalars and waveforms in each mode
How compliance and resistance affect pressure and volume delivery
Clinical scenarios where volume control or pressure control is preferred
Common pitfalls in ventilator management
Whether you’re managing ARDS, COPD, asthma, or undifferentiated respiratory failure, this episode gives you a practical framework to choose the right mode and interpret what the ventilator is telling you in real time.
🎥 Watch the full video version here:https://www.youtube.com/watch?v=qWAWN1Hy49U
📚 Download the full study guide + access our complete emergency critical care curriculum:https://www.patreon.com/c/WhiteBoardMedicine
Our Patreon includes:• Study guides for every video• Mini-courses (ventilation, shock, RRT & more)• Practice questions• Ad-free videos• A structured ICU curriculum
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.

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 alveolar, arterial, and venous pressures interact
Differences between Zone 1, Zone 2, and Zone 3
How position, ventilation, and hemodynamics affect perfusion
Clinical implications in mechanical ventilation, shock, and critical care
Common pitfalls and misconceptions
Whether you’re managing ventilated patients, evaluating hypoxemia, or thinking through V/Q mismatch, this episode provides a clear framework to apply lung physiology in real clinical scenarios.
🎥 Watch the full video version here:https://www.youtube.com/watch?v=AN91NR1UrCQ
📚 Download the full study guide + access our complete emergency critical care curriculum:https://www.patreon.com/c/WhiteBoardMedicine
Our Patreon includes:• Study guides for every video• Mini-courses (ventilation, shock, RRT & more)• Practice questions• Ad-free videos• A structured ICU curriculum
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.

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 oxygenation
The accuracy and limitations of VBG compared to ABG
When a VBG is sufficient—and when an ABG is essential
Common pitfalls in blood gas interpretation
Whether you’re evaluating respiratory failure, metabolic disturbances, or critically ill patients, this episode provides a clear, practical framework for blood gas interpretation in emergency and critical care.
🎥 Watch the full video version here:https://www.youtube.com/watch?v=_wzu4zi19jI
📚 Download the full study guide + access our complete emergency critical care curriculum:https://www.patreon.com/c/WhiteBoardMedicine
Our Patreon includes:• Study guides for every video• Mini-courses (ventilation, shock, RRT & more)• Practice questions• Ad-free videos• A structured ICU curriculum
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.

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 volume
The Frank-Starling relationship and fluid responsiveness
The Fick equation and how cardiac output can be measured
How cardiac output fails in cardiogenic shock
Practical approaches to diagnosis and management in the ICU and ED
Whether you’re managing hypotension, shock, or complex hemodynamics, this episode gives you a clear physiologic framework to guide real-time clinical decision-making.
🎥 Watch the full video version here:https://www.youtube.com/watch?v=CtxfjPTOIRc
📚 Download the full study guide + access our complete emergency critical care curriculum:https://www.patreon.com/c/WhiteBoardMedicine
Our Patreon includes:• Study guides for every video• Mini-courses (ventilation, shock, RRT & more)• Practice questions• Ad-free videos• A structured ICU curriculum
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.

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
Why improper settings can lead to breath stacking and autoPEEP
How to adjust the I:E ratio in obstructive vs restrictive lung disease
Practical bedside applications in mechanically ventilated patients
Whether you’re managing a patient with COPD, asthma, ARDS, or undifferentiated respiratory failure, this episode gives you a clear framework to understand and apply the I:E ratio in real clinical scenarios.
🎥 Watch the full video version here:https://www.youtube.com/watch?v=oahcjS3LWZE
📚 Download the full study guide + access our complete emergency critical care curriculum:https://www.patreon.com/c/WhiteBoardMedicine
Our Patreon includes:• Study guides for every video• Mini-courses (ventilation, shock, RRT & more)• Practice questions• Ad-free videos• A structured ICU curriculum
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.