Sbar
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NomadicMedic
I know a guy who knows a guy.
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I think the R portion of SBAR is only necessary when you're advising an emergency department that they need to have specific interventions ready, i.e.: "respiratory needs to be standing by because the patient is on CPAP."
Otherwise, a short handover is usually best. This is typical for me…
"This is John, he's 65, he's been experiencing substernal chest pain, rated a 10 out of 10 since about eight this morning. Nothing makes it better or worse. I arrived to find him pale and diaphoretic. His 12 lead was nondiagnostic, he's received an inch of paste, three nitros sublingual, 162 mg of aspirin and 100 mics of Fentanyl. Currently rates his pain a two out of 10. He's sinus at 80 with no ectopy, pressure 140/82, respiratory rate of 22 with a non-obstructive end tidal wave form at 38. He only takes simvastatin and has no medication allergies. His wife's out in the waiting room filling out some paperwork… Anything else I can tell you?"
Otherwise, a short handover is usually best. This is typical for me…
"This is John, he's 65, he's been experiencing substernal chest pain, rated a 10 out of 10 since about eight this morning. Nothing makes it better or worse. I arrived to find him pale and diaphoretic. His 12 lead was nondiagnostic, he's received an inch of paste, three nitros sublingual, 162 mg of aspirin and 100 mics of Fentanyl. Currently rates his pain a two out of 10. He's sinus at 80 with no ectopy, pressure 140/82, respiratory rate of 22 with a non-obstructive end tidal wave form at 38. He only takes simvastatin and has no medication allergies. His wife's out in the waiting room filling out some paperwork… Anything else I can tell you?"
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It's not that SBAR is useless, it's that it's unnecessarily lengthy for our purposes. The basic format that was above serves the purpose well and hits the highlights as well as provides an opening for follow-on questions. About the only thing I might add in there is if the patient has any other complaints that I've managed to elicit during transport, and medical history, if it's relatively short. Otherwise I hit the highlights of the history and simply state that the rest is on the paperwork, and that I'll have it done shortly.
If things are more sedate, I'll do the above like DEMedic does, but also toss in brief Head to Toe report of what I've found. In any case, I want to get the verbal report done within about a minute, faster if more acute, and care transferred to the ED staff so that I can finish my written report and then assist in getting ready for another run.
BLS turnover reports can be extremely brief... one was something like this: 66 YOM, found in a parking lot with a short down time, unconscious, unresponsive, no vitals. Bystander started CPR, we continued CPR. Unknown history, meds, allergies. We transported because ALS was extended.
Done.
If things are more sedate, I'll do the above like DEMedic does, but also toss in brief Head to Toe report of what I've found. In any case, I want to get the verbal report done within about a minute, faster if more acute, and care transferred to the ED staff so that I can finish my written report and then assist in getting ready for another run.
BLS turnover reports can be extremely brief... one was something like this: 66 YOM, found in a parking lot with a short down time, unconscious, unresponsive, no vitals. Bystander started CPR, we continued CPR. Unknown history, meds, allergies. We transported because ALS was extended.
Done.
NomadicMedic
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Exactly as Akula says, the more critical, usually the shorter the report.
24-year-old male, head-on collision, ejected through the windshield, unconscious and unresponsive on scene, intubated and bilateral lines.
24-year-old male, head-on collision, ejected through the windshield, unconscious and unresponsive on scene, intubated and bilateral lines.