EM LOGIC

This episode focuses on practical strategies to obtain a high‑yield history that drives accurate ED diagnosis. This includes structured approaches (like OLD CARTS), critical pitfalls to avoid, and specific red flags for conditions such as ACS and dissection. It emphasizes reading the triage note, seeking collateral information from unreliable historians, and resisting anchoring by deliberately con...

ATLS 2025 emphasizes early hemorrhage control (X-ABC's), rapid blood product use with TXA, and updated airway, breathing, and spine protocols, including "spinal protection" and anterior axillary needle decompression. These changes build on 2018's shift toward video laryngoscopy, limited crystalloids, and streamlined transfer practices.

In Episode #43 of EM Logic , Dr. Pregerson reviews common radiology errors in the ED, from missed fractures to subtle tumors, and breaks down why communication and clinical context matter. He also shares real cases and practical tips for improving teamwork with radiologists. Read more in the Show Notes.

In Episode #42 of  EM Logic , Dr. Pregerson highlights new research on occult ventricular fibrillation seen only on bedside echo and reviews the DOSE VF trial showing improved survival with dual sequential defibrillation. He also connects pearls from prior episodes on heads-up CPR and hypokalemic arrest. Read more in the Show Notes.

Don't be blamed for providing inadequate aftercare instructions. Minimize the chances that your discharged patient doesn't return. In Episode #41, Dr. Pregerson covers the pearls and pitfalls of aftercare instructions. Read more details in the Show Notes.

In Episode #40 of  EM Logic , Dr. Pregerson reviews the diagnosis and management of testicular torsion, emphasizing its peak presentation in 13- to 14-year-olds. Epididymitis is the diagnosis on the chart of 61% of settled malpractice cases. He stresses the importance of not waiting for ultrasound before manual detorsion. Read more in the Show Notes .

In Episode #39 of EM Logic, Dr. Pregerson discusses occlusion MIs (OMI) that are missed by STEMI criteria. One-fourth to one-third of NSTEMIs are actually missed acute coronary occlusions, which would be best treated with emergent reperfusion. Read more details here in the Show Notes .

In Episode #38 of EM Logic, Dr. Pregerson reviews what you can do before intubation in order to prevent triggering a subsequent cardiac arrest. Read more details here in the Show Notes. 

In Episode #37 of EM Logic, Dr. Pregerson discusses a paper by Dr. Stephen W. Smith on hyperacute T-waves. STEMI misses 30% to 40% of acute coronary occlusions that would benefit from emergent revascularization. Read more details here in the Show Notes. 

In Episode #36 of EM Logic, Dr. Pregerson reviews the literature and finds on the role of troponin testing in patients with supraventricular tachycardia. SVT conversion and the reasons why diltiazem is better than adenosine is also discussed. Read more details in the Show Notes .

Dr. Pregerson says vital signs are not just normal or abnormal but a continuum. The closer to abnormal they are, the more concerning they should be, of course, but there's still more to learn in this month's podcast. Read more in the Show Notes .

As the literature says, you can't diagnose cyclic vomiting syndrome until you rule out Dietl's crisis. Dr. Pregerson discusses recurrent abdominal pain, which is often diagnosed as CVS, IBS, or abdominal migraine, but notes that Dietl's crisis may present similarly . Read more in the Show Notes .

Knowing how to interpret the literature is an important part of how emergency physicians stay up to date. Dr. Pregerson discusses all kinds of biases, from comparison bias and the Hawthorne effect to outcome bias and publication bias , only in this month's podcast. Read more in the Show Notes . Note from Dr. Pregerson: Thanks to Jerome Hoffman, MD, a giant in emergency medicine and a professor eme...

Dr. Pregerson talks all about the guidelines for reading ECGs, how to minimize interruptions while you're reading them, and ways to build your skills , only in this month's podcast. Read more in the Show Notes .

Dr. Pregerson with how to use ultrasound to diagnose aortic dissection and not miss pericardial effusion, ascending aorta, and dissection flap , only in this month's podcast. Read more in the Show Notes .

Dr. Pregerson tells you the red flags to look for in patients with abdominal pain, green flags that say you're on the right track, and return precautions to give the patient, only in this month's podcast. Read more in the Show Notes

Dr. Pregerson reviews the ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain by focusing on high-sensitivity troponin, delta troponin, unstable angina, renal failure, and baseline troponin, only in this month's podcast. R ead more in the Show Notes .

Dr. Pregerson says assessing temperature in the emergency department is more complicated than you think. He discusses the reliability of thermometers, what constitutes a fever, and how to diagnose hypothermia in this month's podcast. R ead more in the Show Notes .

Dr. Pregerson takes a different approach to finding the cause of metabolic acidosis or alkalosis, delving into the anion gap and discussing mnemonics that can help you make the diagnosis, only in this month's podcast. R ead more in the Show Notes .

Dr. Pregerson said he thinks EPs over-prophylax rabies cases, which carries risks and costs. He discusses the incidence of rabies, which symptoms to look for, and how to treat it in this month's podcast. R ead more in the Show Notes .

Dr. Pregerson said he thinks EPs over-prophylax rabies cases, which carries risks and costs. He discusses the incidence of rabies, which symptoms to look for, and how to treat it in this month's podcast. R ead more in the Show Notes .

Dr. Pregerson has a ll you need to know about strokes, including that posterior strokes are missed twice as often as anterior ones, ruling out mimics like vertigo, headache, and vomiting, and which tests you should be doing in this month's EM Logic podcast. R ead more in the Show Notes .

Dr. Pregerson dives deep into ACLS, noting that anything that compromises good CPR and early defibrillation can make things worse, and he offers tips for treating ED patients who need CPR, defibrillation, intubation, and medications in this month's EM Logic podcast. R ead more in the Show Notes .

Dr. Pregerson parses the literature on steroids for severe infection and why EPs need to know the nuances of how and when to use them in this month's EM Logic podcast. R ead more in the Show Notes .

Hypokalemia gets a lot of attention in the literature, but Dr. Pregerson said he has never had a patient with hyperkalemic cardiac arrest. Listen in as he discusses the ECG changes seen with hypokalemia and how to treat hypokalemic arrest if you see it. R ead more in the Show Notes .