Question

It is 1000 hours in the emergency department (ED) when the ambulance brings in G.G., a 35-year-old man
who is having difficulty breathing. He complains of chest pain and tightness, dizziness, palpitations, nausea,
paresthesia, and feelings of impending doom and unreality; he is having trouble thinking clearly. He
tells you, "I don't think I'm going to make it. I must be having a heart attack." He is diaphoretic and trembling.
His vital signs are 184/92, 104, 28, 98.4 ° F (36.9 ° C). This episode began at work during a meeting at
approximately 0920 and became progressively worse. A co-worker called 911 and stayed with him until
medical help arrived. The patient has no history of cardiac problems. After a full medical workup, it is determined that G.G.'s condition is stable. His shortness of breath and anxiety resolve after he is given lorazepam (Ativan) 1 mg IV push (IVP). The lab work and ECG results are all within normal parameters and there is no evidence of any physical disorder. A diagnosis of panic attack is
made. G.G. admits to having had three similar episodes in the past 2 weeks; however, they were not nearly
as severe or long-lasting. G.G. shares with the ED staff that he has been under severe stress at work and home. He tells them he
is going through a divorce, he lost a child last summer in a motor vehicle accident, and his company is
downsizing. He will probably be out of a job soon. He hasn't been sleeping well for the past couple of
months and has lost about 20 pounds. G.G.'s condition is stable and the ED physician discusses what has happened with G.G. The physician gives G.G. a prescription for a "week's worth" of medication and instructs G.G. to see his primary care physician
for further treatment and evaluation. G.G. tells you all about his worries with his job and all that has happened to him in the past year. He tells
you that he appreciates you listening to him. He expresses fear that the panic attacks will return.

Write a end of shift SBAR report.

Answer 1

END OF SHIFT SBAR REPORT

(S) Situation:

G.G., a 35-year-old man who was having difficulty breathing, complains of chest pain and tightness, dizziness, palpitations, nausea, paraesthesia, and feelings of impending doom and unreality, he was also having trouble thinking clearly. He also told that, "I don't think I'm going to make it. I must be having a heart attack." He is diaphoretic and trembling. A diagnosis of panic attack is made.

(B) Background

It’s was in the emergency department (ED), at 1000 hours ambulance brought in G.G.The episode began at work during a meeting at approximately 0920 and became progressively worse. A co-worker called 911 and stayed with him until medical help arrived.

Three similar episodes happen in the past 2 weeks but not severe.He has been under severe stress at work and home. He tells them he is going through a divorce, he lost a child last summer in a motor vehicle accident, and his company is
downsizing. He will probably be out of a job soon. He hasn't been sleeping well for the past couple of months and has lost about 20 pounds.

(A)Assessment

Vital signs are 184/92, 104, 28, 98.4 ° F (36.9 ° C).

No history of cardiac problems

The lab work and ECG results are all within normal parameters and there is no evidence of any physical disorder.

He expresses worries about his job and fear that the panic attacks will return.

(R) Recommendation

He was given lorazepam (Ativan) 1 mg IV push (IVP). His shortness of breath and anxiety resolved and condition become stable

Physician gives G.G. a prescription for a "weeks’ worth" of medication and instructs G.G. to see his primary care physician for further treatment and evaluation.