Clinical Tips
Quick and practical tips for your nursing practice
🧠 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
🎯 FAIR: Syncope vs. Seizure
F — Fatal: Missed cardiac syncope, prolonged seizure, airway compromise A — Assess: FAST-R → Face color, After/before,
📋 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
💡 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
🎯 FAIR: Cold vs Warm Shock in Children
F — Fatal: Wrong vasopressor match worsens outcomes; up to 30% of children convert phenotypes mid-resuscitation A — Ass
⚠️ Up to 30% of children convert shock phenotypes during resuscitation
Most common shift: warm → cold decompensation. The vasopressor that was correct 30 minutes ago may now be wrong. Watc
🎯 FAIR: Blood Pressure in Acute Stroke
F — Fatal: BP extremes kill brain — both hyper- and hypotension cause harm U-shaped curve A — Assess: Reperfusion statu
📋 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
📊 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
💡 Vomiting + Pain WITHOUT Diarrhea = Think Surgery
True gastroenteritis typically includes diarrhea. Its absence is significant. With diarrhea: Gastroenteritis likely me
👤 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
💡 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