Communication

Communication

1. Doctors and nurses: ISBAR

   • Example: Identify: "Hello, this is Niru, the Paeds HMO Situation: "I have a 3 month old in ED with severe respiratory distress I am worried about" Background: "The child came in 3 hours ago and has got progressively worse.  They have had a previous PICU admission and needed a non-invasive ventilation for bronchiolitis 5 weeks ago and only went home 10 days ago" Assessment: "Their respiratory rate is 75, with marked tug and recession.  They have bilateral wheeze and crepitations.  On 6L of oxygen the saturations are 97%.  Central capillary refill is 3 seconds" Response: I think this infant is unwell and they may need to be transferred to an intensive care unit for non-invasive ventilation.  I would like you to come and see them please"

2. Documentation

   • "Asked to evaluate (patient's name) for (fever, chest pain, wheezing).  Vital signs are... (dont' state stable as they can be abnormal but still stable).  Cardiorespiratory exam normal.  No signs of sepsis, shock or meningitis.  Paracetamol ordered for pain control.  Consultant notified.  Discussed with nursing staff and family  Always record the time and date in on-call documentation.