Clinical Tips
Quick and practical tips for your nursing practice
š§ SBAR for FRID Communication
S: "I'm concerned about fall risk for Mrs. Dorothy" B: "She's on 4 FRIDs including sertraline increased 1 week ago, que
šÆ FAIR: Syncope vs. Seizure
F ā Fatal: Missed cardiac syncope, prolonged seizure, airway compromise A ā Assess: FAST-R ā Face color, After/before,
š HEART Score Quick Reference
H History: 0 atypical / 1 moderate / 2 highly suspicious E ECG: 0 normal / 1 nonspecific / 2 ST deviation A Age: 0 <45
š” The 10-Minute ECG: Not Aspirational. Standard of Care.
AHA/ACC guidelines: 12-lead ECG within 10 minutes for ALL chest pain patients. Not just the ones who look sick. Not ju
šÆ FAIR: Cold vs Warm Shock in Children
F ā Fatal: Wrong vasopressor match worsens outcomes; up to 30% of children convert phenotypes mid-resuscitation A ā Ass
ā ļø Up to 30% of children convert shock phenotypes during resuscitation
Most common shift: warm ā cold decompensation. The vasopressor that was correct 30 minutes ago may now be wrong. Watc
šÆ FAIR: Blood Pressure in Acute Stroke
F ā Fatal: BP extremes kill brain ā both hyper- and hypotension cause harm U-shaped curve A ā Assess: Reperfusion statu
š The 15-30-60 Monitoring Protocol
0-2h post-tPA: Every 15 minutes critical period 2-8h post-tPA: Every 30 minutes 8-24h post-tPA: Every 60 minutes After
š 40-50% of pediatric appendicitis is initially misdiagnosed
Bilious vomiting in a neonate? The midgut can necrose within hours. 50%+ of malrotation presents before 1 month of age
š” Vomiting + Pain WITHOUT Diarrhea = Think Surgery
True gastroenteritis typically includes diarrhea. Its absence is significant. With diarrhea: Gastroenteritis likely me
š¤ Robert, 67, "I just feel really weak"
UTI on antibiotics "that aren't working." Breathing fast. Warm skin. Thready pulse. RR-MIND-BP in 60 seconds at triage
š” How to escalate: Name the score, state the risk
Don't say: "The patient doesn't look good." Say: "Mrs. Johnson in 412 has pneumonia with qSOFA of 2. RR 24, newly conf