In the September 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss vaginal bleeding and hyponatremia managment. As always, you’ll also hear about the hot topics covered in the regular features, including a young man with heart palpitations in The Critical ECG, a child with purple vesicles in Clinical Pediatrics, hallux sesamoid fractures in Critical Cases in Orthopedics and Trauma, spermatic cord block in The Critical Procedure, the ISPAD 2022 Guidelines Summary in The LLSA Literature Review, a patient with a thumb injury in The Critical Image, droperidol in The Drug Box, and barium toxicity in The Tox Box.