A flight nurse is transporting a 45-year-old male with a severe traumatic brain injury. Mid-flight, the patient's GCS drops from 9T to 6T, his heart rate decreases to 50 bpm, his blood pressure rises to 190/110 mmHg, and his right pupil becomes fixed and dilated. When providing an updated SBAR report to the receiving trauma center, which statement best represents the 'Assessment' portion?
My assessment is that the patient is actively herniating based on the new onset of Cushing's triad and a unilateral blown pupil.
This is Flight-Comm with an updated report on our TBI patient. Our new estimated time of arrival is 10 minutes.
Just as a reminder, this patient was found at the bottom of a 20-foot ladder and was intubated on scene by the ground crew.
I recommend having the neurosurgery team present for our arrival and preparing for immediate administration of hyperosmolar therapy.
The 'Assessment' component of SBAR involves the nurse's professional conclusion about the current situation. The statement that the patient is actively herniating accurately synthesizes the new vital signs (Cushing's triad) and neurological findings into a clinical judgment. This is the core of the Assessment. The other options represent different, distinct parts of the SBAR report: providing an update on location and ETA is part of the 'Situation'; stating the mechanism of injury and initial interventions is 'Background'; and requesting a neurosurgeon on arrival and preparing for specific treatments is a 'Recommendation'.
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BCEN CFRN
General Principles of Flight Transport Nursing Practice
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