WhiteBoard Medicine - Emergency And Critical Care

#165 Fluid Assessment in Critical Care | CVP, PPV, PLR, and IVC Ultrasound Explained

How do you assess fluid status at the bedside? In this episode, we break down the four main fluid assessment strategies used in emergency and critical care: 🔹 Central Venous Pressure (CVP) – static, trend-based but poor predictor of fluid responsiveness 🔹 Pulse Pressure Variation (PPV) – dynamic and strong evidence in the right conditions 🔹 Passive Leg Raise (PLR) – safe, reversible preload challenge valid across rhythms and ventilation 🔹 Inferior Vena Cava (IVC) Ultrasound – quick, non-invasive, helpful in extremes of volume status
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You’ll learn: The physiology behind each method 🧠 Step-by-step how to use them at the bedside 🛠️ Strengths and limitations ⚖️ A quick comparison table 📋 Evidence-based pearls 📚 3 practice board-style questions (beginner, intermediate, advanced) 📝 This video is a high-yield resource for medical students, residents, and ICU/critical care clinicians who want to improve their understanding of fluid management in shock.
Link to video: https://www.youtube.com/watch?v=XyoEbyROxRg
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.

#164 IVC Ultrasound Assessment Explained | Fluid Status & Volume Responsiveness Emergency Critical Care

Inferior Vena Cava (IVC) ultrasound is a simple, fast, and non-invasive bedside tool for estimating volume status and fluid responsiveness. By assessing the IVC diameter and its respiratory variation, clinicians can better guide resuscitation — especially in shock or critically ill patients.
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In this episode, we cover: What IVC ultrasound assessment is and why it matters 🩻 How to measure the IVC step by step (probe choice, view, diameter, M-mode) 🛠️ Collapsibility and distensibility indices explained 📏 Clinical interpretation in spontaneously breathing vs mechanically ventilated patients 🩺 Rules of thumb: tiny/collapsible vs dilated/non-collapsing IVC Strengths, limitations, and pitfalls ⚠️ Evidence base and guidelines for IVC use 📚 A practical bedside algorithm for fluid assessment 🔀 3 board-style practice questions (beginner, intermediate, advanced) 📝
Link to video: https://www.youtube.com/watch?v=jImOBX0OTuI 
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.

#163 Passive Leg Raise (PLR) Explained | Fluid Responsiveness & Bedside Tips

The Passive Leg Raise (PLR) test is one of the most reliable and safest ways to assess fluid responsiveness at the bedside — without giving unnecessary IV fluids. By mobilizing ~300–500 mL of venous blood centrally, PLR provides a reversible preload challenge that can guide resuscitation in critically ill patients.
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In this episode, we cover: What the Passive Leg Raise test is and how it works 🧠 Step-by-step guide on how to perform PLR correctly 🛠️ What constitutes a positive PLR response (SV/CO ↑ ≥10–15%) 📊 When PLR is most useful (shock, septic patients, weaning pressors, high-risk fluid cases) ✅ Contraindications and pitfalls 🚫 Evidence base supporting PLR vs. static measures like CVP and IVC ultrasound 📚 Clinical pearls and board-style practice questions 📝
Link to video: https://www.youtube.com/watch?v=x5Y6i62fCc0 
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.

#162 Pulse Pressure Variation (PPV) Explained | Fluid Responsiveness & Bedside Tips

Pulse Pressure Variation (PPV) is one of the most reliable bedside tools for assessing fluid responsiveness in mechanically ventilated ICU patients. Unlike static measures such as CVP, PPV uses arterial waveform analysis to predict whether a patient will benefit from fluids.
📚 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
In this episode, we cover: What PPV is and the physiology behind it 🫀 Step-by-step method to calculate PPV from the arterial line 🧮 Clinical thresholds: ≥13%, ≤9%, and the “gray zone” 📊 The tidal volume challenge and adjunct tests (PLR, mini-fluid challenge) Strengths, pitfalls, and when PPV is unreliable ⚠️ Evidence from meta-analyses and sepsis guidelines A quick bedside algorithm for real-world use 🔀 3 board-style practice questions (beginner to advanced) 📝
Link to video:https://www.youtube.com/watch?v=hgBYp7U6skY
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.

#161 Sympathomimetic Toxicity Explained | Cocaine, Meth, MDMA & Stimulant Overdose

Sympathomimetic toxicity is a common emergency medicine presentation, often caused by cocaine, methamphetamine, MDMA, and stimulant medications. These cases can mimic other toxidromes and may progress to life-threatening hyperthermia, arrhythmias, seizures, or multi-organ failure.
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In this video, we cover: What sympathomimetics are and common agents (cocaine, meth, MDMA, stimulants) 💊 Mechanism of toxicity: catecholamine excess (NE, dopamine, serotonin) 🔬 Clinical presentation: agitation, tachycardia, hypertension, diaphoresis, chest pain, seizures 🩺 Diagnostic workup and differentiating from anticholinergic toxidrome ED/ICU management: benzodiazepines first line, cooling, fluids, avoid pure β blockers 🚑 Complications: rhabdomyolysis, hyperthermia, ACS, stroke, hyponatremia Prognosis, pearls, and practice questions for learners
Link To Video Version:https://www.youtube.com/watch?v=UL_YJ6oOZNY
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.

#160 Beta Blocker Overdose BB OD Explained | Toxicity, Management & Antidotes

Beta blocker overdose is one of the most dangerous cardiovascular emergencies, leading to bradycardia, hypotension, seizures, and cardiogenic shock. Agents like propranolol, metoprolol, carvedilol, and atenolol can cause life-threatening toxicity, especially with ER formulations or co-ingestions.
📚 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
In this podcast, we cover: What beta blockers are and why overdoses are so dangerous 💊 Mechanisms of toxicity: β1/β2 blockade, sodium channel blockade, lipophilicity, and QT prolongation 🔬 Clinical presentation: bradycardia, shock, seizures, bronchospasm, hypoglycemia 🩺 Emergency management: airway/IV access, glucagon, HIET (high-dose insulin therapy), vasopressors, sodium bicarbonate, lipid emulsion, ECMO 🚑 Diagnostic workup and monitoring strategies in the ED/ICU Prognosis, pearls, and practice questions for learners
Link To Video Version:https://www.youtube.com/watch?v=Y2zwZl323j0
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.

#159 Shock Index Made Easy ⚡ | Trauma, Sepsis, Pregnancy & Critical Care Applications

The Shock Index (SI) is one of the simplest but most powerful bedside tools in emergency medicine and critical care. Defined as heart rate divided by systolic blood pressure (HR ÷ SBP), SI often outperforms vital signs alone for detecting occult shock.
📚 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 Video Version: https://www.youtube.com/watch?v=0CoHL94ALB4
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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.

#158 Sepsis & Septic Shock Explained | Pathophysiology, Phenotypes & More 🦠

Sepsis and septic shock remain some of the most critical conditions in emergency medicine and critical care. 🦠 In this video, we start with the basics of sepsis and septic shock before moving into more advanced topics: sepsis-induced cardiomyopathy, sepsis pathophysiology, and sepsis phenotypes. Learn how to recognize, understand, and manage sepsis from the ground up.
📚 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
Timestamps: 0:00 - 22:01 - Sepsis Basic Concepts 20:02 - 45:44 - Septic Shock Overview 45:45 - 1:03:25 - Septic Shock Advanced Pathophysiology 1:03:26 - 1:25:09 - Sepsis Induced Cardiomyopathy (SICM) 1:25:10 - 1:41:23 - Sepsis Phenotypes
Link to YouTube Video: https://www.youtube.com/watch?v=l6eq1MoOUCs
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.

#157 Mastering Acute Hypoxemic Respiratory Failure – ABG, VBG, Aa Gradient, Chest Xray, Interpretation

In this episode, we break down how to approach acute hypoxemic respiratory failure at the bedside. You’ll learn step-by-step interpretation of arterial blood gases (ABG), venous blood gases (VBG), alveolar-arterial (Aa) gradient, and using the chest x-ray and ABG to diagnose the cause. We’ll cover the physiology, practical interpretation pearls, and common pitfalls so you can confidently apply this knowledge in the ICU, ED, or wards.
Link To YouTube Video: https://www.youtube.com/watch?v=g-6Qn5dmyxU
📚 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
Timestamps: 0:00 - 15:02 - Arterial Blood Gas Sampling and Analysis 15:03 - 30:14 - Venous Blood Gas Sampling and Analysis 30:15 - 42:22 - Using, Calculating, and Understanding the Aa Gradient 42:23 - 53:32 - Diagnosing Cause of Hypoxemia Using ABG and CXR
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.

#156 Cardiac Physiology Made Simple | Pressures, Output, Preload & More 🫀

Master the fundamentals of cardiac physiology — from chamber pressures and cardiac output to preload, afterload, contractility, and the Fick equation. 🫀 This episode breaks down complex hemodynamics and devices into simple, high-yield concepts for exams and bedside care. Perfect for medical students, residents, fellows, nurses, physiologists, and clinicians in emergency medicine, critical care, and cardiology.
📚 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
Timestamps: 0:00 - 9:46 - Cardiac Chamber Pressures, Pulmonary Artery Catheters, Central Venous Catheters 9:47 - 36:46- Cardiac Output, Heart Rate, Preload, Contractility, Afterload 36:47 - 51:37 - Fick Equation, Explanation, Derivation
Link to YouTube Video: https://www.youtube.com/watch?v=YrVITCyZhzk
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.