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.

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.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.

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.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.

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.

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.

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.