Vasopressin is often thought of as just a “second-line pressor” — but its physiology and clinical applications are far more nuanced.

In this episode, we break down vasopressin from the ground up, starting with receptor-level physiology and how it differs from catecholamines, then build into a focused deep dive on one of its most important uses: right ventricular (RV) failure and pulmonary hypertension.

We cover:

• V1, V2, and V3 receptor physiology
• How vasopressin affects systemic vs pulmonary vascular tone
• Differences from norepinephrine and other vasopressors
• Why vasopressin can be uniquely helpful in RV failure
• Practical bedside considerations in shock states

This episode is designed for medical students, residents, fellows, nurses, respiratory therapists, and practicing clinicians looking to better understand vasopressor selection in emergency and critical care.

🎯 Want the full breakdown? Get downloadable study guides, clinical frameworks, and a complete emergency critical care curriculum here: 👉 https://www.youtube.com/watch?v=P0Ic2UY3A1Y

⚠️ Disclaimer: This content is for educational purposes only and does not constitute medical advice. Clinical decisions should be based on individual patient context, institutional protocols, and professional judgment.

In this episode, we break down VExUS ultrasound (Venous Excess Ultrasound Score) and how to assess venous congestion at the bedside in critically ill patients.

We walk through the physiology of venous congestion and how to integrate IVC ultrasound, hepatic vein Doppler, portal vein Doppler, and renal venous Doppler into a practical framework for evaluating fluid tolerance vs fluid overload. This is a powerful tool for clinicians managing patients in the ICU and emergency department who are trying to decide when to give fluids—and when to stop.

If you’ve ever struggled with fluid status assessment, this episode will help you move beyond isolated measurements and toward a more comprehensive, physiology-based approach.

🎥 Watch the full video here: https://www.youtube.com/watch?v=aeXJxP-emWk

Get the full study guide for this episode + complete emergency critical care curriculum: https://www.patreon.com/c/WhiteBoardMedicine

Our Patreon includes: • 📄 Study guides for every episode • 🎓 Mini-courses (ventilation, shock, RRT & more) • ❓ Practice questions • 🚫 Ad-free content • 🧠 A structured ICU curriculum

This content is for educational purposes only and is not intended to provide medical advice. Clinical decisions should be made based on individual patient circumstances, institutional protocols, and clinician judgment. This content does not represent the views of any affiliated institutions.

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.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.