SAMPLE ISBAR

SAMPLE 1: HYPERTENSIVE EMERGENCY (MEDICAL

Situation:
"Mrs. Johnson is a 68-year-old female who arrived at the clinic complaining of severe headache,
blurred vision, and shortness of breath. Her blood pressure on arrival was measured at 200/120
mmHg."

Background:
"Mrs. Johnson has a past medical history significant for hypertension, for which she takes
amlodipine 10 mg daily. She denies any recent changes in her medication regimen or any recent
illnesses. She reports a history of poorly controlled blood pressure readings, but this is the first
time she has experienced symptoms like this."

Assessment:
"Based on her symptoms and elevated blood pressure reading, Mrs. Johnson is likely experiencing
a hypertensive emergency. She appears anxious and is complaining of chest discomfort. There are
no signs of focal neurological deficits at this time."

Recommendation:
"I recommend initiating immediate interventions to lower Mrs. Johnson's blood pressure. Please
administer a short-acting antihypertensive medication such as labetalol or nitroglycerin
sublingually. Recheck her blood pressure every 5-10 minutes and aim for a gradual reduction in
blood pressure to target levels (systolic BP < 160 mmHg and diastolic BP < 100 mmHg) over the
next hour. Notify the attending physician for further evaluation and management. Continuous
monitoring of vital signs and assessment for signs of end-organ damage, such as neurological
deficits or signs of heart failure, is crucial. We should also obtain an ECG and basic laboratory
studies, including electrolytes, renal function, and cardiac enzymes, to assess for any
complications related to the hypertensive emergency."
SAMPLE 2: ANAPHYLACTIC SHOCK (EMERGENCY ROOM)
Introduction:
"Good evening Dr. Mohammed, this is [Your Name] calling from the ER. I'm reporting on a
patient, Mr. Patel, who is currently in the emergency room presenting with symptoms of
anaphylactic shock."

Situation:
"Mr. Patel is a 35-year-old male who arrived at the ER via ambulance approximately 20 minutes
ago. He is experiencing difficulty breathing, swelling of the face and throat, and generalized
urticaria. His initial vital signs upon arrival were blood pressure 80/50 mmHg, heart rate 140 beats
per minute, respiratory rate 28 breaths per minute, and oxygen saturation 88% on room air."

Background:
"Mr. Patel has a known allergy to peanuts and accidentally ingested a food item containing peanuts
approximately 30 minutes prior to the onset of symptoms. He has a history of mild asthma but
denies any recent exacerbations. He has not taken any medications or interventions prior to
arrival."

Assessment:
"Based on his clinical presentation and history of peanut allergy, Mr. Patel is likely experiencing
anaphylactic shock. He appears anxious and is struggling to breathe. There are no signs of focal
neurological deficits at this time."

Recommendation:
"I recommend initiating immediate interventions to stabilize Mr. Patel's condition. Please
administer intramuscular epinephrine 0.3 mg (1:1000) into the lateral thigh. Start supplemental
oxygen via a non-rebreather mask at 15 liters per minute and initiate continuous cardiac
monitoring. Prepare for possible advanced airway management and intravenous fluid resuscitation.
Additionally, administer intravenous diphenhydramine and ranitidine to address histamine-
mediated symptoms. Notify the attending physician and the ICU team for further evaluation and
management. Continuous monitoring of vital signs, including frequent reassessment of respiratory
status and oxygen saturation, is crucial. We should also obtain baseline laboratory studies,
including complete blood count, electrolytes, and serum tryptase levels, to assess for any
complications related to anaphylactic shock."
SAMPLE 3: ARTERY EMBOLIZATION PROCEDURE
(INTERVENTIONAL RADIOLOGY)
Introduction:
"Good morning Dr. Abdullah, this is [Your Name] from Interventional Radiology. I'm calling to
provide a report on our patient, Mrs. Smith, who is scheduled for a uterine artery embolization
procedure."

Situation:
"Mrs. Smith is a 45-year-old female presenting with symptomatic uterine fibroids, including heavy
menstrual bleeding and pelvic pain. She has failed medical management and is scheduled for
uterine artery embolization to alleviate her symptoms."

Background:
"Mrs. Smith has a significant medical history of uterine fibroids and is otherwise healthy. She has
undergone imaging studies confirming the presence of multiple fibroids, with the largest
measuring 8 cm. She has provided informed consent for the procedure and has been prepped and
draped in the angiography suite."

Assessment:
"Based on her clinical presentation and imaging findings, Mrs. Smith is an appropriate candidate
for uterine artery embolization. She is currently stable and has received pre-procedure sedation for
comfort."

Recommendation:
"I recommend proceeding with the uterine artery embolization procedure as planned. Please ensure
all necessary equipment and supplies are ready, including catheters, embolic agents, and
fluoroscopy guidance. Begin by accessing the femoral artery using sterile technique and advancing
the catheter under fluoroscopic guidance to the uterine artery. Administer the embolic agents
bilaterally to achieve occlusion of the uterine arteries. Monitor vital signs, including blood pressure
and oxygen saturation, throughout the procedure. Post-procedure, transfer Mrs. Smith to the
recovery area for monitoring and pain management. Provide post-procedure instructions and
arrange for follow-up imaging to assess treatment efficacy."
SAMPLE 4: VAGINAL BLEEDING (OB-GYNE CLINICS)
Introduction:
"Hello and good morning Dr. Atyaf, this is [Your Name] calling from the OB-GYN clinic. I'm
reporting on a patient, Ms. Adams, who is currently in our clinic presenting with vaginal bleeding."

Situation:
"Ms. Adams is a 25-year-old nulligravida woman who arrived at the clinic reporting vaginal
bleeding for the past 24 hours."

Background:
"Ms. Adams reports that the bleeding started suddenly without any preceding trauma or
intercourse. She describes the bleeding as moderate in amount, bright red in color, and without
clots. She denies any associated symptoms such as abdominal pain, fever, or vaginal discharge.
Her last menstrual period was approximately four weeks ago, and her cycles are typically regular."

Assessment:
"Based on Ms. Adams' presentation, vaginal bleeding of unknown etiology is concerning. Given
her reproductive age and absence of other symptoms, differential diagnoses may include early
pregnancy complications such as threatened miscarriage, ectopic pregnancy, or other
gynecological causes such as cervical polyps or vaginal infections. Assessment of her vital signs
reveals stable blood pressure and heart rate. Physical examination findings are within normal
limits."

Recommendation:
"I recommend conducting a thorough evaluation to determine the cause of Ms. Adams' vaginal
bleeding. Perform a pelvic examination to assess for cervical lesions, uterine size, and any
evidence of active bleeding. Consider obtaining a transvaginal ultrasound to evaluate the uterine
and adnexal structures, as well as to assess for intrauterine pregnancy or ectopic pregnancy. Collect
samples for laboratory testing, including a complete blood count and quantitative beta-hCG to
assess for pregnancy and possible pregnancy-related complications. If necessary, consult with the
attending OB-GYN provider for further evaluation and management. In the meantime, provide
supportive care, including reassurance, and advise Ms. Adams to abstain from sexual intercourse
until further evaluation is completed."