In this episode of Hospital Medicine Unplugged, we demystify inpatient cellulitis—who to admit, what to cover, and when to stop. We open with the right patients: nonpurulent, warm, tender, spreading erythema—and the red flags for a bed (systemic toxicity, rapid progression, immunocompromise, failed outpatient therapy, hand/face, or NSTI concern). Use bedside ultrasound to unmask abscess; skip routine blood cultures unless severe, immunocompromised, or unusual exposure. Mark borders and reassess ...
Sep 24, 2025•28 min
In this episode of Hospital Medicine Unplugged, we get practical about inpatient pyelonephritis—how to stop sepsis, protect kidneys, and prevent complications. We open at the door: recognize sepsis, two IV lines + fluids, draw urine and blood cultures (don’t delay antibiotics for tough sticks), check creatinine and lactate, and assess for obstruction/retention. Then hit bugs fast—empiric IV antibiotics tailored to local resistance and risk of MDR: • Ceftriaxone (many hospitalized patients) or ce...
Sep 24, 2025•31 min
In this episode of Hospital Medicine Unplugged, we tackle Clostridioides difficile infection (CDI) on the wards—fast, practical, guideline-driven care from test ordering to recurrence prevention. We open with the first moves: test only the right patient—≥3 unformed stools in 24 h (or ileus/toxic megacolon). Use a two-step algorithm: GDH + toxin EIA up front; NAAT as the tiebreaker if discordant. No “test of cure.” While labs cook, fix the basics: stop the inciting antibiotic if you can (or narro...
Sep 23, 2025•27 min
In this episode of Hospital Medicine Unplugged, we demystify PFO workup and closure after ischemic stroke—who to test, who to close, and how to run a tight inpatient pathway. We open with the right patients: nonlacunar, embolic-appearing infarcts in adults 18–60 with no better cause on initial workup. Everyone gets vascular imaging, inpatient rhythm monitoring, DVT screening, and risk-factor assessment before we even say “PFO.” Then the diagnostics that matter: start with TTE + agitated-saline b...
Sep 23, 2025•33 min
In this in-depth episode of Hospital Medicine Unplugged , we tackle the evidence-based inpatient management of lower gastrointestinal bleeding (LGIB)—from first contact in the ED to secondary prevention at discharge. We start with stabilization and triage: ABCs, two large-bore IVs, targeted labs, and a restrictive transfusion strategy—generally transfuse at Hb <7 g/dL (aim >7), or >9 g/dL if significant cardiovascular disease or ongoing instability. We cover how to separate brisk UGIB f...
Sep 23, 2025•30 min
In this episode of Hospital Medicine Unplugged , we unpack the evidence-based inpatient management of upper gastrointestinal bleeding (UGIB)—from triage at the door to secondary prevention at discharge. We open with stabilization: airway protection when mental status or torrential hematemesis threatens, two large-bore IVs, targeted labs (CBC, CMP, coagulation studies, type & cross), and a restrictive transfusion strategy (Hb <7 g/dL for most; <8 g/dL if CAD or ongoing massive bleed). W...
Sep 23, 2025•34 min
In this in-depth episode of Hospital Medicine Unplugged , we walk through the evidence-based hospital management of decompensated cirrhosis. From triage to discharge, we cover the full playbook hospitalists need on the wards. We start with rapid assessment and risk stratification—how to find precipitating factors (infection, GI bleed, alcohol, meds/nephrotoxins), what to order up front (CBC, CMP, INR, cultures), and how to use MELD-Na and ACLF scores to guide level of care. Next, we hit the time...
Sep 23, 2025•39 min
In this in-depth episode of Hospital Medicine Unplugged , we walk through evidence-based inpatient care for opioid use disorder (OUD)—from triage to transition of care—so hospitalists can start, continue, and optimize medications for opioid use disorder (MOUD) on the wards. We start with bedside assessment and risk stratification—confirming OUD by history and DSM-5, using the Clinical Opiate Withdrawal Scale (COWS) to time inductions, and ordering high-yield labs (CBC, CMP, HIV/HBV/HCV, pregnanc...
Sep 23, 2025•26 min
In this in-depth episode of Hospital Medicine Unplugged, we discuss acute coronary syndromes (ACS)—why minutes matter, how to sort risk fast, and the exact moves from triage to discharge. We frame the stakes (plaque rupture → thrombus → myocardium at risk), then run a time-zero checklist: 12-lead ECG within 10 minutes (repeat if nondiagnostic), high-sensitivity troponin on a 0/1–2-hour pathway, telemetry, and GRACE/TIMI to separate low/intermediate/high risk. Use bedside echo for wall-motion clu...
Sep 23, 2025•34 min
In this in-depth episode of Hospital Medicine Unplugged, we tackle alcohol withdrawal syndrome (AWS)—why it’s high-stakes on the wards, how to risk-stratify fast, and exactly what to do from triage through discharge. We open with the “why”: AWS is common, dangerous, and time-sensitive. We review the pathophysiology (rebound CNS hyperexcitability after abrupt cessation) and the clinical spectrum—from mild tremor and autonomic surge to seizures and delirium tremens—framing why early recognition ch...
Sep 22, 2025•35 min•Season 1Ep. 6
In this in-depth episode of Hospital Medicine Unplugged, we walk through the evidence-based inpatient management of acute decompensated heart failure (ADHF)—from the ED door to safe discharge and early follow-up. We frame every step around two goals: rapid, complete decongestion and in-hospital optimization of guideline-directed medical therapy (GDMT) to change long-term outcomes. We start with triage and diagnosis: how to profile “wet/warm” vs “wet/cold,” read the neck veins like a pro, and use...
Sep 22, 2025•32 min•Season 1Ep. 5
In this in-depth episode of Hospital Medicine Unplugged, we walk through the evidence-based hospital management of anemia in the inpatient setting—a condition that affects nearly half of hospitalized adults and directly impacts morbidity, length of stay, and readmission risk. From first-line diagnosis to tailored therapy, we cover the practical tools hospitalists need on the wards. We start with classification and diagnostic approach: Confirming anemia with age- and sex-specific hemoglobin cutof...
Sep 22, 2025•37 min•Season 1Ep. 4
In this in-depth episode of Hospital Medicine Unplugged, we walk through the evidence-based hospital management of gram-positive bacteremia, one of the most critical scenarios hospitalists face. From first-line antibiotic selection to workup and follow-up, we cover the full spectrum of care needed on the wards. We start with antibiotic therapy—why cefazolin or antistaphylococcal penicillins (nafcillin/oxacillin) remain the gold standard for MSSA, and how vancomycin and daptomycin are the pillars...
Sep 22, 2025•36 min•Season 1Ep. 3
In this in-depth episode of Hospital Medicine Unplugged, we walk through the evidence-based hospital management of pulmonary embolism (PE) and deep vein thrombosis (DVT). From bedside diagnosis to long-term follow-up, we cover the full spectrum of care hospitalists need on the wards. We start with diagnosis and risk stratification—how to use Wells criteria, D-dimer, ultrasound, and CT angiography effectively, and when imaging can safely be avoided. For PE, we break down high-risk (massive), inte...
Sep 22, 2025•30 min•Season 1Ep. 2
In this episode of Hospital Medicine Unplugged, we explore the evolving science and clinical realities of community-acquired pneumonia (CAP) in hospitalized adults. Drawing from leading journals such as The New England Journal of Medicine and JAMA , we walk through practical approaches every hospitalist needs when managing pneumonia on the wards. We start with diagnosis: recognizing new infiltrates on chest imaging in the right clinical context, and how severity scoring tools like the Pneumonia ...
Sep 22, 2025•29 min•Season 1Ep. 1
