Summary of SBAR Communication Framework
SBAR Communication Framework: A Student's Guide to Mastering It
Introduction
SBAR (Situation, Background, Assessment, Recommendation) is a structured communication tool widely used in emergency medicine to convey critical patient information efficiently and safely. It reduces ambiguity, speeds decision-making, and helps ensure handovers and referrals are consistent and actionable.
SBAR is a concise, standardized framework for clinical communication that improves clarity and patient safety.
Why SBAR matters in Emergency Medicine
- Emergencies demand rapid, accurate information exchange between nurses, paramedics, and physicians.
- SBAR provides a predictable format so the receiver can quickly grasp priorities and act.
- It reduces omissions and misinterpretations during high-stress situations.
SBAR broken down
S — Situation
- Purpose: Grab attention and state the immediate problem.
- Include: your identity, role, location, patient identification (name, gender, age), and the reason for the call in one clear sentence.
Example: Hello, this is Dr Novak from the Emergency Department. I’m calling regarding Mrs Smith, a 65-year-old female with sudden pressure chest pain for 30 minutes.
Key elements to include under Situation:
- Identifying yourself: name, role, department/location
- Patient ID: name, surname, gender, age
- One-line reason: current chief complaint, onset, duration, and severity
B — Background
- Purpose: Provide relevant medical context that affects diagnosis and management.
- Include: pertinent past medical history, current medications, allergies, and any other context (recent events, social factors) that affect care.
Example: She has a history of hypertension, type 2 diabetes, and hypercholesterolemia. Medications include Prestarium, Metformin, and statins. No known allergies (NKA).
When to be concise:
- Only include background items that change treatment choices (e.g., anticoagulants, insulin, allergies).
A — Assessment
- Purpose: Present objective data and your clinical impression.
- Include: vital signs, focused physical findings, investigations (e.g., ECG), and a working/suspected diagnosis.
- Always report measured values and whether they are pre- or post-treatment when therapy was given.
Example: Mrs Smith's SpO2 was 91% (now 96% on O2). Current vitals: RR 22/min, BP 180/100 mmHg, pulse 105/min, CRT 3 s, BGL 5.0 mmol/L, Temp 36.8°C. ECG shows ST-elevations in chest leads. Suspected diagnosis: Acute Myocardial Infarction.
Assessment checklist:
- SpO2, RR, BP, pulse, CRT, BGL, Temp, neurological status (AVPU, orientation)
- Document changes after interventions (e.g., O2 increased SpO2 from 91% to 96%)
Clinical triggers and suggested immediate actions:
- SpO2 < 95%: administer oxygen via mask
- Systolic BP < 100 mmHg: consider Normal Saline bolus
- BGL < 3.0 mmol/L: give IV glucose; BGL 3.0–3.9 mmol/L: oral glucose if safe
R — Recommendation
- Purpose: State clearly what you want the recipient to do.
- Include: specific requests (e.g., immediate bedside assessment, order tests, start medications, activate catheterization lab).
Example: I request immediate cardiology consultation and activation of the cath lab; give 300 mg aspirin now if not contraindicated.
How to make recommendations effective:
- Be specific and time-sensitive
- Offer your suggested next steps and any alternatives
Practical examples and role-play scripts
- Short prehospital-to-ED handover
- Situation: "Hello, this is Paramedic Lee from Ambulance 12. I’m handing over Mr Jones, a 72-year-old male with sudden onset shortness of breath for 20 minutes."
- Background: "History of CHF and atrial fibrillation; on warfarin and furosemide; NKA."
- Assessment: "SpO2 88% on room air (improved to 94% on 6 L O2), RR 28/min, BP 150/90, pulse irregular 110/min, CRT 4 s. BNP pending. Suspect acute decompensated heart failure."
- Recommendation: "Please continue oxygen, obtain chest X-ray, and start diuretics; request cardiology review if no improvement."
- In-hospital nu
Sign up for the full summaryAlready have an account? Sign in
SBAR Emergency Communication
Klíčové pojmy: Identify yourself with name, role, and location at the start, State patient ID: name, gender, and age in the Situation, Give a one-sentence reason with onset, duration, and severity for Situation, Include only relevant medical history, current medications, and allergies in Background, Report objective measured values in Assessment: SpO2, RR, BP, pulse, CRT, BGL, Temp, neurological status, Always note pre- and post-treatment vitals after interventions, Make specific, time-bound recommendations in Recommendation (e.g., consult, activate service), Use SBAR for rapid, focused communication to reduce omissions and errors, Prepare before the call: gather vitals and documents to be concise, Confirm the plan and expected timeframe to close the loop, For SpO2 < 95% give oxygen; systolic BP < 100 mmHg consider IV fluids; BGL < 3.0 mmol/L give IV glucose, Practice SBAR with role-play and simulations for proficiency