WhiteBoard Medicine - Emergency And Critical Care

Unstable lower gastrointestinal bleeding is a high-acuity emergency that can rapidly progress to hemorrhagic shock, massive transfusion, and death if not recognized and managed appropriately. In this episode, we review the resuscitation, diagnostic evaluation, and definitive management of unstable lower GI bleeding from an emergency medicine and critical care perspective.

Topics covered include recognition of hemorrhagic shock, ini...

Hepatic encephalopathy is one of the most common and clinically important complications of advanced liver disease and cirrhosis. It is a frequent cause of altered mental status encountered by emergency physicians, intensivists, hospitalists, gastroenterologists, hepatologists, and other healthcare professionals caring for critically ill patients.

In this episode, we review the pathophysiology of hepatic encephalopathy, including am...

Esophageal variceal bleeding is one of the most dangerous gastrointestinal emergencies encountered in emergency medicine, critical care medicine, hospital medicine, and gastroenterology. Rapid recognition and appropriate early management can significantly impact outcomes, making this a must-know topic for healthcare professionals caring for acutely ill patients.

In this episode, we review the pathophysiology of portal hypertension ...

Mechanical circulatory support devices are increasingly used to manage cardiogenic shock, advanced heart failure, cardiac arrest, and severe cardiopulmonary failure. Yet many clinicians struggle to understand how devices such as intra-aortic balloon pumps (IABP), extracorporeal membrane oxygenation (ECMO), and left ventricular assist devices (LVADs) fit together within a broader framework of critical care support.

In this Mechanica...

Monitors are everywhere in the ICU, emergency department, operating room, and procedural areas—but understanding what those monitors are actually telling you is a completely different skill.

In this ICU Bedside Monitoring Masterclass, we bring together some of the most important concepts in invasive hemodynamic monitoring and waveform interpretation. We cover arterial lines, central venous pressure (CVP) monitoring, end-tidal...

Respiratory Support Masterclass: From Nasal Cannula to AVAPS

Respiratory support exists on a spectrum—from conventional oxygen therapy to advanced noninvasive ventilation. Understanding how and when to escalate support is a foundational skill in emergency medicine, critical care medicine, respiratory therapy, and hospital medicine. Selecting the appropriate respiratory support modality can improve oxygenation, reduce work of ...

Noninvasive Ventilation Masterclass: BPAP, AVAPS & Key Differences Explained

Noninvasive ventilation (NIV) is a cornerstone of respiratory support in emergency medicine, critical care medicine, respiratory therapy, and hospital medicine. Understanding how BPAP and AVAPS work, when to use each modality, and how to optimize settings can help clinicians manage respiratory failure while potentially avoiding invasive mechanical vent...

Oxygen Delivery Devices Explained: Nasal Cannula, Face Mask, HFNC & BPAP

Choosing the appropriate oxygen delivery device is a fundamental skill in emergency medicine, critical care medicine, respiratory therapy, and hospital medicine. From low-flow oxygen therapy to advanced noninvasive respiratory support, understanding how each device works can help clinicians optimize oxygenation while recognizing the advantages and limitati...

High-Flow Nasal Cannula (HFNC) Explained: Physiology, Settings & Clinical Applications

High-Flow Nasal Cannula (HFNC) has become one of the most important respiratory support modalities in emergency medicine, critical care medicine, respiratory therapy, and hospital medicine. By delivering heated, humidified oxygen at high flow rates, HFNC can improve oxygenation, reduce work of breathing, wash out anatomic dead space, and prov...

AVAPS vs BPAP: Key Differences, Settings & Clinical Applications

BPAP and AVAPS are two commonly used forms of noninvasive ventilation, but understanding how they differ and when each mode may be appropriate can be challenging. While BPAP delivers fixed pressure support through preset IPAP and EPAP settings, AVAPS adds a target tidal volume and automatically adjusts inspiratory pressure support to help maintain that goal.

In th...

AVAPS Explained: Indications, Settings, Physiology & Clinical Applications

Average Volume-Assured Pressure Support (AVAPS) is an advanced mode of noninvasive ventilation that combines pressure support ventilation with a target tidal volume. By automatically adjusting inspiratory pressure support to achieve a desired tidal volume, AVAPS can help provide more consistent ventilation in patients with acute and chronic hypercapnic r...

BPAP Explained: Indications, Settings, Troubleshooting & Clinical Applications

BPAP (Bilevel Positive Airway Pressure) is one of the most commonly used forms of noninvasive ventilation in emergency medicine, critical care medicine, respiratory therapy, and hospital medicine. Understanding when to use BPAP, how to adjust settings, and how to recognize treatment failure is essential for clinicians caring for patients with acute r...

COPD Exacerbation Explained: Oxygen, Bronchodilators, Steroids & Ventilation

Acute exacerbations of COPD are among the most common causes of emergency department visits, hospital admissions, respiratory failure, and ICU admissions. Understanding the pathophysiology of COPD exacerbations and the principles of respiratory support is essential for clinicians caring for critically ill patients.

In this episode, we review the evalua...

Toxicologic emergencies are common in emergency medicine and critical care, yet the underlying physiology and management strategies can become complex quickly. Early recognition and aggressive supportive care are often critical to improving outcomes.

In this ICU toxicology masterclass, we review four high-yield toxicologic emergencies every clinician should recognize: • Beta blocker toxicity • Calcium channel blocker (CCB) toxicity...

Serotonin syndrome and neuroleptic malignant syndrome (NMS) are two life-threatening toxicologic emergencies that every emergency medicine physician, intensivist, hospitalist, nurse, pharmacist, and trainee should recognize early.

In this toxicology deep dive, we review: • Neuroleptic malignant syndrome (NMS) • Serotonin syndrome • Key clinical differences • Pathophysiology • Causative medications • Hyperthermia • Clonus vs rigidit...

Nutrition support is a core component of modern critical care medicine, yet ICU feeding strategies can become confusing quickly. When should we use enteral nutrition vs parenteral nutrition? What are trophic feeds? Should we check gastric residual volumes? How do we approach aspiration risk?

In this episode, we break down the fundamentals of ICU nutrition and feeding strategies including: • Enteral vs parenteral nutrition • Gastric...

Serotonin syndrome and neuroleptic malignant syndrome (NMS) are two life-threatening toxicologic emergencies that can appear very similar at the bedside — but recognizing the key differences is critical for emergency department and ICU management.

In this episode, we focus on the high-yield differences between serotonin syndrome and neuroleptic malignant syndrome including: • Clonus vs rigidity • Hyperreflexia • Medication tr...

Serotonin syndrome is a potentially life-threatening toxicologic emergency caused by excess serotonergic activity. Early recognition is critical in the emergency department, ICU, inpatient wards, and prehospital settings.

In this episode, we review the fundamentals of serotonin syndrome including: • Pathophysiology • Serotonergic medications • Hyperthermia • Clonus and hyperreflexia • Neuromuscular findings • Autonomic instability ...

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 • Hyperthermi...