Critical Care Specialty

ICU Critical Care SBAR Template

Engineered for the intensive care unit. Integrates invasive hemodynamic lines, mechanical ventilator settings, continuous vasoactive drip titrations, RASS sedation scoring, and multi-organ system parameters.

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Why ICU SBAR Communication Differs

In the ICU, patients have multi-organ dysfunction with continuous physiological monitoring. A generic report lacks the precision required by intensivists. ICU SBAR expands each component to account for invasive arterial blood pressure (MAP), ventilator synchrony and ABG trends, vasopressor dose trajectories, and neurological sedation targets.

Invasive Hemodynamics: Arterial line MAP, CVP, PA catheters, and exact vasopressor titration rates.

Advanced Airway & Vent: Mode, PEEP, FiO2 %, P/F ratio, peak pressures, and endotracheal tube depth.

Sedation & Delirium: RASS score (-5 to +4), CAM-ICU status, paralytic depth, and neuro-checks.

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ICU Clinical Scenario Example

Severe ARDS & Shock Escalation

Clinical FrameworkSTAT / Emergent

ICU Bedside Nurse-to-Intensivist Emergency SBAR

Refractory hypoxemia and escalating vasopressor requirement

Patient: Arthur Pendelton (64yo M)

Bed/Room: ICU Bed 4

MRN: MRN-902148

Attending: Dr. Al-Mansoor (Intensivist)

Situation

Immediate clinical concern & reason for calling right now

• Nurse Marcus, BSN, RN (Bedside ICU RN) calling Dr. Al-Mansoor (On-Duty Intensivist). • Calling regarding Bed 4-ICU: Arthur Pendelton (64yo M with severe ARDS secondary to aspiration pneumonia). • Immediate Concern: Sudden refractory hypoxemia (SpO2 86% on 80% FiO2), worsening peak inspiratory pressures (Ppeak 38 cmH2O), and escalating Norepinephrine requirement (titrated from 0.08 to 0.22 mcg/kg/min) over the last 45 minutes.

Background

Relevant clinical history, admitting diagnosis, medications & baseline

• Intubated 36 hours ago (7.5 ETT @ 22cm at teeth). • History: COPD (GOLD Stage 3), Coronary Artery Disease s/p stent, CKD Stage 3. • Current Vent Settings: PRVC mode, Rate 22, Vt 420 mL (6 mL/kg PBW), PEEP 14 cmH2O, FiO2 80%. • Lines & Access: Right internal jugular triple lumen CVC; Left radial arterial line (zeroed, crisp waveform). • Active Infusions: Norepinephrine @ 0.22 mcg/kg/min, Vasopressin @ 0.03 units/min, Propofol @ 35 mcg/kg/min, Fentanyl @ 100 mcg/hr. • Code Status: Full Code. Allergies: Penicillin (Anaphylaxis).

Assessment

Current vital signs, objective physical findings & clinical interpretation

• Hemodynamics: A-line BP 88/52 (MAP 64), HR 114 sinus tach, CVP 12 mmHg. • Pulmonary / Ventilator: PaO2 on recent STAT ABG is 56 mmHg (P/F ratio 70 = Severe ARDS). Static compliance decreased to 22 mL/cmH2O. Bilateral coarse crackles, right base diminished. • Neuro / Sedation: RASS -4 (deep sedation), pupils 3mm equal and reactive. • Renal: Urine output 15 mL/hr over past 2 hours via temp-sensing Foley catheter. Serum Lactate increased to 3.4 mmol/L.

Recommendation / Request

Specific clinical action needed, timeframe & read-back confirmation

• I recommend you evaluate the patient at bedside immediately. • I request orders for: 1. Initiating Prone Positioning Protocol (16-hour cycle) for refractory severe ARDS. 2. Starting continuous Neuromuscular Blockade (Cisatracurium infusion) with train-of-four monitoring. 3. STAT Portable Chest X-Ray to rule out pneumothorax secondary to elevated airway pressures. 4. Adding Stress-Dose IV Hydrocortisone 50mg Q6H for refractory septic shock.

Looking for more critical care and septic shock communication examples?Explore ICU Septic Shock Example on SBAR Examples →

Blank Critical Care SBAR Worksheet Layout

Patient / Bed: __________________

Vent Mode / FiO2: _________ %

PEEP / Rate / Vt: _____________

ETT Size & Depth: ________ cm

Active Drips: _________________

Lines (A-line/CVC): ___________

RASS / CAM-ICU: ____________

UOP (mL/hr) / CRRT: _________

[S] SITUATION (ICU):Acute physiological decompensation, trigger, MAP or PaO2 crisis...

[B] BACKGROUND (ICU):Days intubated, baseline organ function, active vasopressors/sedatives, culture status...

[A] ASSESSMENT (ICU):A-line BP/MAP, ABG (pH/PaCO2/PaO2/HCO3/Lactate), peak pressures, UOP trend, RASS score...

[R] RECOMMENDATION (ICU):Bedside evaluation, vent changes (proning, paralysis, iNO), inotrope/pressor additions, line placement...

Authoritative Critical Care References:

1. Society of Critical Care Medicine (SCCM). Surviving Sepsis Campaign & ICU Interprofessional Communication Guidelines.

2. American Association of Critical-Care Nurses (AACN). Standards for Establishing and Sustaining Healthy Work Environments: Skilled Communication.

Clinical Communication Notice

Medical Disclaimer: This ICU SBAR template is an educational communication tool and does not replace emergency resuscitation protocols, ACLS algorithms, or ECMO/Critical Care physician decision-making.

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