SBAR Communication tool Part 2

• SBAR stands for Situation, Background, Assessment, and Recommendation
• SBAR is an easy to use structured communication tool for communicating with emergency services.
• The US military originally developed SBAR for communication on nuclear submarines.
• SBAR has been introduced into clinical settings, relating to patient safety, acute illness, and calling for help to emergency services.
• Mistakes when handling information during a phone call can cost lives.

Situation, Background, Assessment, Recommendation

• Key components of SBAR include situation, background, assessment, and recommendation.
• Situation involves identifying yourself/site, the patient by name, the reason for the report, and the specific situation of concern.
• Background involves explaining significant medical history, patient's background, possible diagnosis, admission date, current medications, allergies, and relevant lab/diagnostic results.
• Assessment involves vital signs, clinical impressions, and concerns.
• Recommendation involves what you need, being specific about the request and time frame, making suggestions, and expectation clarification.

Calling 999/Handover - SBAR

• How information is delivered on the phone may affect how the patient is categorized.
• NHS England and NHS Improvement's national framework (2019) offers guidance to call handlers categorizing 999 calls made by community-based healthcare professionals (HCPs), like dentists.
• Medical emergencies in the dental practice are likely categorized as categories 1 and 2.
• Four categories are defined by emergency services, to ensure effective communication and handover.

Consider the following

• Tips when communicating during emergencies:
  • Listen: Hear and follow instructions despite stress.
  • Talk slowly: Be mindful of how you speak while stressed.
  • Use the right words
  • Location: Provide accurate location information, use nearby landmarks, and be aware that postcode may not work.
  • Someone wait outside
  • Handover verbal and in writing
  • Next of kin
  • Go to the hospital

Cardiac Emergencies

• Types of cardiac emergencies: angina, myocardial infarction (MI), and cardiac arrest.

Angina

• For known angina patients, remember they do not typically lose consciousness.
• Administer GTN spray (400-800mcg) with 2 actuations.
• Repeat if no relief.
• Give aspirin unless allergic.
• Call 999 SBAR
• Be prepared for CPR.

MI

• MI (myocardial infarction): Death of heart muscle due to loss of blood supply, potentially serious.
• The patient may lose consciousness.
• Give aspirin unless allergic.
• Call 999 SBAR
• Be prepared for CPR.

Cardiac Arrest

• Cardiac arrest is a sudden loss of heart function.
• The patient collapses and loses consciousness.
• Call 999 SBAR
• CPR

Sign and Symptoms

• Cardiac emergency signs and symptoms may include:
  • Sudden onset
  • Chest pain/crushing/pressure/heaviness
  • Pain in arm/neck/jaw/stomach
  • Sweaty/light-headed
  • Nausea