ScienceHealth & FitnessMedicine

EM LOGIC

Brady Pregerson, MD

The EM Logic Podcast was born of 20 years of observation that errors in medicine often occur not because of limited knowledge or being unaware of the latest literature but because the provider was on autopilot or failed to use basic logic in decision-making.

EM Logic is meant to compliment but never replace what health care providers learn in medical school, residency, and the evidence-based literature. It is meant to get you thinking rather than just following management algorithms you have learned during your career.

Dr. Pregerson will focus on the pitfalls of confusing cause with coincidence, being falsely reassured by normal tests, and getting burned by illogical assumptions. He hopes it will improve the care you provide and your patients' outcomes, and keep you from being an honored guest at your department's next peer review meeting.

Dr. Pregerson has been practicing emergency medicine since 2000, lecturing and writing about medical topics since 2004, and has reviewed more than 180 malpractice cases since 2008. He is the author of three EM pocket references, the creator of EMresource.org and EM1minuteconsult.com, and the author of the EMN column BradyCardia (http://bit.ly/BradyCardiaEMN.

If you would like to be considered as a guest on a future episode, contact Dr. Pregerson at Safetydoc@gmail.com.

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20 episodes
monthly
Avg 15 min
English

Episodes 20

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September 2 · 23 min
Episode 49 – Early Sepsis Logic
Late sepsis is early to diagnose but catching the early signs is more critical. Don't miss these clinical pearls on inflammatory markers and much more.
August 4 · 21 min
Episode 48: Ureteral Stone Logic
Most ureteral stones pass on their own, but a few demand urgent intervention. Learn the "PENIS" framework for spotting high-risk patients and avoiding the catastrophic mistake of missing an infected obstructing stone. Read More in the Show Notes
March 3 · 20 min
Episode #45: History 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 considering rare, dangerous diagnoses first.
Dec 1, 2025 · 14 min
Episode #44: ATLS UPDATE
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.
Oct 1, 2025 · 17 min
Episode #43: Radiologist Errors
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.
Sep 2, 2025 · 15 min
Episode #42: Resuscitation
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.
Aug 1, 2025 · 13 min
Episode #41: Aftercare Revisited
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.
Jul 1, 2025 · 16 min
EM Logic Episode #40: Testicular Torsion Logic
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.
May 30, 2025 · 17 min
EM Logic Episode #39: ACS ECG Logic
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.
Apr 30, 2025 · 13 min
EM Logic Episode #38: Resuscitation Before Intubation Logic
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.
Mar 31, 2025 · 10 min
EM Logic Episode #37: Hyperacute T-Wave Logic
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.
Feb 28, 2025 · 9 min
March 2025 Episode #36: SVT Logic
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.
Dec 31, 2024 · 18 min
January 2025: Vital Signs Logic
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.
Nov 27, 2024 · 15 min
December 2024: Diagnostic Momentum Logic
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.
Oct 31, 2024 · 17 min
November 2024: Literature Logic
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 emeritus at the UCLA School of Medicine, for reviewing this topic with me.
Sep 30, 2024 · 11 min
October 2024: Triage ECG Logic
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.
Aug 30, 2024 · 10 min
September 2024: Aortic Dissection Logic
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.
Jul 31, 2024 · 16 min
August 2024: Abdominal Pain Logic
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
Jun 28, 2024 · 12 min
July 2024: Delta Troponin Logic
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. Read more in the Show Notes.
May 30, 2024 · 12 min
June 2024: Temperature Logic
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. Read more in the Show Notes.

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