Another one, cirrhotic patients that have peritonitis are at increased risk of secondary bacterial peritonitis. Broaden out your antibiotics and get imaging early.

All admitted, decompensated liver patients WITH as it’s need a diagnostic tap. Up to 10% will have SBP on fluid analysis.

I like to think of these as Regular, Really Wide Tachycardia (RRWT) and it should always trigger an assumption of metabolic/tox as an underlying cause. Initial management is sodium bicarb and calcium!