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Guides Cliniques
Des micro-briefs de preuves pour les questions d'hospitalisation — créés avec inScope, notre moteur de preuves cliniques, et relus avant publication.
Tachyarrhythmias in Hospitalized Adults: Stabilize, Classify, and Treat
Inpatient tachyarrhythmias: unstable → cardiovert; narrow vs wide, regular vs irregular; AF rate control drugs and doses; SVT, VT, and anticoagulation.
Acute Decompensated Heart Failure: Evaluation and Management
Acute decompensated heart failure: IV loop diuresis and dosing, volume monitoring, starting quadruple GDMT before discharge, and when to escalate.
Acute Asthma Exacerbation: Evaluation and Treatment
Acute asthma exacerbation: inhaled SABA, early systemic steroids, ipratropium and IV magnesium for severe attacks, oxygen to 93–95%, and escalation.
Acute COPD Exacerbation: Evaluation and Treatment
The acute COPD exacerbation bundle: bronchodilators, a 5-day steroid course, when antibiotics help, controlled oxygen to 88–92%, and early NIV.
Acute Kidney Injury: Definitions, Tests, and Imaging for a Systematic Evaluation
Acute kidney injury on the wards: KDIGO staging, prerenal vs intrinsic vs postrenal causes, urine microscopy, FENa and FEUrea, ultrasound, dialysis triggers.
SIADH: Diagnosis and Management
SIADH evaluation and management: the diagnostic criteria, fluid restriction as first-line, hypertonic saline for severe symptoms, avoiding overcorrection.
How fast can serum sodium be corrected safely in chronic hyponatremia?
Safe sodium correction rates in chronic hyponatremia, who is at high risk of osmotic demyelination, and what to do after overcorrection.
Choledocholithiasis: Who Goes Straight to ERCP, Who Gets MRCP or EUS First
Common bile duct stones: ASGE high/intermediate/low risk, when MRCP or EUS comes before ERCP, recognizing cholangitis, and same-admission cholecystectomy.
Constipation in Hospitalized Patients: Evaluation, Stepwise Laxatives, and Opioid-Induced Constipation
Inpatient constipation: red flags first, then osmotic → stimulant → rectal therapy with doses, PAMORAs for opioid-induced constipation, agents to avoid in CKD.
Acute Cholecystitis: Diagnosis, Severity Grading, and When to Operate
Acute cholecystitis: ultrasound diagnosis, Tokyo severity grading, antibiotics, early laparoscopic cholecystectomy, and cholecystostomy for high-risk patients.
Acute Appendicitis: Diagnosis, Appendectomy vs Antibiotics-First, and Complicated Disease
Acute appendicitis: confirming uncomplicated disease on CT, empiric antibiotics, appendectomy vs antibiotics-first, and managing abscess or perforation.
Small vs Large Bowel Obstruction: How to Distinguish and Manage Them in Hospitalized Patients
Bowel obstruction on the wards: telling SBO from LBO on CT, NG decompression, the contrast challenge, ischemia red flags, and when to operate or stent.
C. difficile Infection in Hospitalized Patients: Who to Test, How to Grade It, and How to Treat It
C. difficile in hospitalized adults: who to test, severity grading, fidaxomicin vs oral vancomycin, fulminant disease, recurrence, and isolation.
Antibiotic Stewardship in Hospitalized Patients, Part 2: S. aureus Bacteremia, Endocarditis, Meningitis, and Vertebral Osteomyelitis
Antibiotic stewardship, part 2: bundles, timing rules, surgical triggers, and multi-week courses for S. aureus bacteremia, endocarditis, meningitis, and spine.
Antibiotic Stewardship in Hospitalized Patients, Part 1: Principles, Common Pathogens, and Empiric Choices
Inpatient antibiotics, part 1: the stewardship loop, complicated vs uncomplicated, which bugs cause which infections, empiric regimens with doses, durations.
Community-Acquired Pneumonia: Diagnosis and Treatment
Community-acquired pneumonia: confirming the diagnosis, empiric antibiotics by severity, when to cover MRSA/Pseudomonas, oral switch, and ICU escalation.
Acute Respiratory Failure: When to Use Nasal Cannula, High-Flow, BiPAP, or Invasive Ventilation
Acute respiratory failure: FiO2 and flow limits for nasal cannula, masks, Venturi, high-flow, BiPAP, and the ventilator, and when to step up to the next device.
Septic Shock: Initial Resuscitation and Management
Septic shock: early broad-spectrum antibiotics, protocolized fluid resuscitation, norepinephrine to a MAP ≥ 65, source control, and lactate clearance.
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