*7.1.1 SBAR*

One such method commonly used by hospitals is the SBAR approach, which is conveying information regarding the situation, background, assessment, and recommendations, in that order, for every handoff and request for evaluation or


**Table 2.** *Structure handoff formats.*

## *Patient Safety in Emergency Medical Services DOI: http://dx.doi.org/10.5772/intechopen.108690*

intervention. In hospitals, this has been shown to improve safety of patients during handoff [30]. Though this has not been tested in an EMS environment, this can be applied to a patient handoff to maximize patient safety.

1.*Situation:* Who are you providing treatment to and for what? How high is the acuity of this patient's condition? What were you called to the scene for?

*Example: Ms. Smith is a 56-year-old female in significant respiratory distress. Her husband reports that she has asthma and has tried her albuterol inhaler several times today without relief from her symptoms.*

2.*Background*: What relevant medical information or prescribed medications are pertinent to the current condition?

*Example: She takes both inhaled corticosteroids and a leukotriene modifier daily and has not missed any doses. She has not required oral steroids for her asthma recently but was intubated 2 years ago for a severe asthma exacerbation.*

3.*Assessment*: What were the critical diagnostic or physical exam findings? What interventions were attempted? How effective were they?

*Example: She was found in a tripod position, respiratory rate of 36, SpO2 82% on room air, with both nasal flaring and intercostal retractions, and minimal air movement on lung auscultation. She was given two duonebs and 125mg solumedrol and also placed on supplemental oxygen via nasal cannula, resulting in a slight improvement in SpO2 but no change in respiratory rate, work of breathing, or lung sounds.*

4.*Recommendations*: What do you feel are the necessary next steps? EMS providers are encouraged to make recommendations within their respective scope of practice, as an EMS clinician's continued assessments and resulting concerns are helpful in directing immediate care.

*Example: Because of her continued respiratory distress despite nebulizer treatments, steroids, and oxygen administration, I am concerned that she may need further interventions, such as noninvasive positive pressure ventilation or intubation.*
