Overview

It is 2:47 a.m., the rapid response is paged to bed 14, the patient is hypotensive on three home antihypertensives and a new antibiotic, the chart is forty pages deep, and the next decision belongs to you. Default frameworks built around younger, single-diagnosis patients miss the prescribing cascade, miss the early sepsis, miss the AKI buried in a creatinine that ""looks normal,"" and turn a recoverable admission into a discharge to skilled nursing the family never expected. This handbook rebuilds inpatient reasoning around the patient actually in front of you - multimorbid, medicated, time-sensitive, and one decision away from a different trajectory. Inside this book: - Mechanism-anchored management - convert pathophysiology into bedside orders for HFrEF, HFpEF, ACS, and the hypertensive crisis on the overnight pager - Time-critical pathways - door-to-needle in stroke, lactate-to-antibiotic in sepsis, source control in necrotizing infection, with the institutional levers that move those clocks - Rebalanced hemostasis in cirrhosis - stop transfusing FFP for an INR that does not predict bleeding, and paracentese the patient who actually needs it - Sodium and potassium recalibrated - correction rates that protect the brain, hyperkalemia management beyond calcium and insulin, acid-base reasoning that survives the morning rounds - GDMT optimization that the outpatient setting missed - the four-pillar heart failure regimen built before discharge, not deferred to clinic - Goals-of-care as a procedure - SPIKES, REMAP, and Serious Illness Conversation Guide deployed with the realism CPR survival data demands - Bedside ultrasound as standard of care - thoracentesis, paracentesis, and central access at complication rates the landmark era never reached For hospitalists, internists, geriatricians, family physicians, nurse practitioners, physician assistants, pharmacists, residents, fellows, and medical students caring for hospitalized adults. Buy the book. Round better tomorrow.

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