Emergency & Resuscitation Specialty

Emergency Department (ED) SBAR Template

Engineered for the chaotic emergency environment. Adapts SBAR to handle Emergency Severity Index (ESI) triage acuity, pre-hospital EMS transfer data, time-critical code activations (STEMI, Stroke, Trauma), and seamless admission handoffs.

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Why Emergency Department SBAR Context Differs

Emergency medicine operates under high diagnostic uncertainty and extreme time pressure. The patient is often unknown to the care team, requiring immediate integration of pre-hospital EMS field interventions, triage acuity categorization (ESI 1-5), and time-sensitive code clocks (Door-to-Balloon, Door-to-Needle).

Triage Acuity & LKW: ESI Level (1-5), Chief Complaint, and exact Last Known Well (LKW) timestamp.

Pre-Hospital Synthesis: Paramedic field vitals, field medications given, and mechanism of injury.

Rapid Disposition: Transfer to Cath Lab, Trauma OR, ICU admission, or floor bed placement.

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Emergency Department Clinical Example

Acute Code STEMI Activation

Clinical FrameworkSTAT / Emergent

Emergency Department Nurse-to-Specialist SBAR

Code STEMI activation and direct Cath Lab transfer

Patient: Kenneth Hayes (54yo M)

Bed/Room: ED Trauma Bay 2

MRN: MRN-882194

Attending: Dr. Reynolds (Interventional Cardiology)

Situation

Immediate clinical concern & reason for calling right now

• Nurse Carlos, RN (ED Trauma/Resus Bay) calling Dr. Reynolds (On-Call Interventional Cardiologist). • Patient: Kenneth Hayes (54yo M), arrived via EMS 12 minutes ago under Code STEMI protocol. • Immediate Concern: Ongoing crushing substernal chest pain (10/10) radiating to left arm with 3mm ST-segment elevations in inferior leads (II, III, aVF) on initial ED 12-lead ECG.

Background

Relevant clinical history, admitting diagnosis, medications & baseline

• Arrived via Medic 14 at 18:42; symptom onset at 18:05 while at home. • Pre-Hospital Course: EMS administered Aspirin 324mg PO chewable and Sublingual Nitroglycerin 0.4mg x2 with minimal pain relief. Established 18G IV in left antecubital fossa. • Past Medical History: Hypertension, 25 pack-year smoking history, Hyperlipidemia. No prior known CAD. • Allergies: NKDA. Code Status: Full Code. Weight: 92 kg.

Assessment

Current vital signs, objective physical findings & clinical interpretation

• Vitals on arrival: BP 152/92, HR 64 regular (sinus bradycardia with occasional junctional escape), RR 20, SpO2 98% on room air, Temp 36.9°C. • Physical Exam: Diaphoretic, pale, cool extremities. Heart sounds regular S1/S2 without murmurs. Lungs clear to auscultation bilaterally. • Diagnostic ECG: Confirms acute inferior-wall STEMI with reciprocal ST depression in leads I and aVL. Bedside point-of-care Troponin-I is elevated at 1.8 ng/mL.

Recommendation / Request

Specific clinical action needed, timeframe & read-back confirmation

• Activate the Cardiac Catheterization Team for immediate primary PCI (Door-to-Balloon target <90 min). • Requesting orders for: 1. IV Heparin weight-based bolus (60 units/kg = 5,500 units STAT). 2. Oral P2Y12 inhibitor loading dose (Ticagrelor 180mg PO STAT). 3. Continuous 12-lead telemetry monitoring while transporting directly to Cath Lab Suite 2.

Looking for acute emergency and neurological escalation scenarios?Explore Acute Stroke Alert Example on SBAR Examples →

Blank Emergency Department SBAR Layout

Patient / Age: _______________

ESI Acuity: [1] [2] [3] [4] [5]

Arrival Mode: EMS / Walk-in

LKW / Onset Time: __________

Chief Complaint: ____________

EMS Meds: _________________

Code Status: Full / DNR

Target Unit: ICU / Floor / OR

[S] SITUATION (ED):Chief complaint, arrival time, immediate acute emergency or code protocol...

[B] BACKGROUND (ED):Mechanism of injury, pre-hospital field course, pertinent medical history, allergies...

[A] ASSESSMENT (ED):Initial ED vitals, physical exam, FAST exam/CT/ECG findings, point-of-care labs...

[R] RECOMMENDATION (ED):Cath Lab/OR transfer, admission bed type (ICU vs telemetry), STAT orders requested...

Authoritative Emergency Nursing References:

1. Emergency Nurses Association (ENA). Emergency Nursing Standardized Handoff and Transition Guidelines.

2. American College of Emergency Physicians (ACEP). Emergency Resuscitation & Interfacility Transfer Protocols.

Clinical Communication Notice

Medical Disclaimer: This Emergency Department SBAR template is an educational communication tool and does not supersede ACLS/ATLS resuscitation algorithms, emergency medical triage judgment, or trauma team activation standards.

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