In the October 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss managing thermal burns and diabetic ketoacidosis and hyperosmolar state. As always, you’ll also hear about the hot topics covered in the regular features, including syncope and a rapid heartbeat in a young man in The Critical ECG, a boy with hip pain in Clinical Pediatrics, calcaneal fracture in Critical Cases in Orthopedics and Trauma, wedge resection for partial nail removal in The Critical Procedure, albuterol-budesonide rescue inhalation for asthma in The LLSA Literature Review, a patient with a change in mental status in The Critical Image, phenobarbital for alcohol withdrawal syndrome in The Drug Box, and paraquat toxicity in The Tox Box.