| A | B |
|---|
| 88 yr male with new onset severe bradycardia | Quick Assess: Vitals Signs, Mental Status, Rhythm strip, Medication Review, Other devices & symptoms |
| 77 yr female with new onset slurred speech, facial droop, arm drift | Quick Assess with neuro exam for possible stroke, trauma? fall? Review meds, increase VS, Focus SBAR on possible diagnosis of stroke for intervention. Time Critical. |
| 65 yr male with diabetes, preop for colorectal surgery in 4 hours, now unresponsive | Quick Assess: Fingerstick, VS, rule out hypoglycemia, check EKG for possible ischemia, review meds. |
| 97 yr female with bradycardia new onset 4 days after admission. Review of orders shows "Same orders as med reconciliation sheet." Patient lethargic, poor historian. VS 90/40 P 40. On admit, pulse 77. | Quick Assess: BRR, cooling extremities. Check EKG for block, SSS, ischemia, ext pacer handy, code status?, Review MAR, BUN, Cr for reversible med component. |
| 55 yr male with Benign prostatic hypertrophy and CHF got benedryl for sleep, now short of breath 12 hours later. | Quick Assess: VS, exam for distended bladder. UOP check... Review meds. Possible urinary retention from benedryl. |
| 76 yr female, not eating and weak, fell in bathroom tonight. Large bruise over L hip. Patient with Afib. | Quick Assess: Check for head trauma. Med review: Look for anticoagulation. If patient not eating, INR may be high. Ask MD for CBC, INR, PT, inc VS, neuro checks. Fall prevention plan needed. |
| 79 year male with fever to 102, cough with yellow sputum, shortness of breath and BP 90/60 (usual 150/90), P 110, confusion. | Quick Assess: Think possible early sepsis, pneumonia. How long has the patient been in the hospital? O2, Think Blood cultures, quick serum lactate, CBC, chemistries. SBAR focused on possibilities of early sepsis and pneumonia(? nosocomial). |
| 66 year male with shortness of breath new onset with confusion. Pt is s/p MI 2 days ago. | Quick Assess: Ischemia? Dysrhthymia? Hypoxia? Check Rhythm, exam looking for CHF, Check UOP. O2, Bedbound? PE risk? Think of what labs etc. you might need to request. |
| 50 yr male with fractured hip, post op day 5. Pain is managed with Demerol. He is renal insufficient. Pt is confused and combative. | Quick Assess: Vital Signs. Last BM. Check for impaction. Demerol causes neurotoxicity and then seizures by accumulating in renal insufficiency. SBAR focus at least on Demerol as well as other issues uncovered.... |
| 88 year lady, (code status: DNR) with grunting respirations (rate 30) and distended abdomen. You are called you for assessment of comfort. NKDA. | Quick Assess: Last BM? Evidence of grimacing? Bladder distention? Exam finds distension of bladder and impaction. Make your SBAR presentation. What medicines might help? |
