SBAR Urgent Paediatric Referral Template

(Do not include any information where the data is missing from a subsection and try to limit repetition.) SBAR Urgent Paediatric Referral Template Referral Details Young Person Name: [Young person's full name] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) DOB: [Date of birth] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Use format DD/MM/YYYY.) NHS Number: [NHS number] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) Referred by: [Referrer name] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) Referrer's Department within CAMHS: [Department name] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely.) Referrer's contact number: "0300 123 6632 (Portsmouth) 0300 123 6617 (Southampton)" Date and Time of referral: [Date and time of referral] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Use format DD/MM/YYYY and 24-hour time.) [Current risk assessment] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief structured summary.) ACTION FOR PAEDIATRICS: [Clear and direct actions for paediatrics team] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief bullet points.) ACTION FOR GP: [Clear and direct actions for GP] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief bullet points.) ACTION FOR CAMHS: [Clear and direct actions for CAMHS team] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief bullet points.) ACTION FOR PARENTS / CARERS: [Clear and direct actions for parents or carers] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief bullet points.) ACTION FOR PATIENT: [Clear and direct actions for patient] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief bullet points.) SBAR[One sentence summary of problem with reference to MEED red flags areas] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as single sentence without full detail.) Situation [Summary of current presentation and concerns from today] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write in brief paragraphs of full sentences.) [Physical observations and weight loss] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write in brief paragraphs of full sentences.) [Co-occurring physical symptoms or behaviours and their duration including chest pain, food/fluid refusal] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write in brief paragraphs of full sentences.) Background [Working diagnosis] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Do not invent or infer a diagnosis. Write as brief statement.) [Treatment plan and duration in treatment] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief statement.) [Any comorbid mental or physical health diagnosis] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Do not invent or infer a diagnosis. Write as brief list.) [Rapidity of weight loss including whether acute or chronic, with MEED risk rating] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief statement.) [Premorbid weight with timeframe for weight changes] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief statement.) [Current food and fluid intake or stage of meal plan, including estimate of current daily calorie intake] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief statement.) [Compensatory behaviours including laxatives, purging, excessive exercise] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief list.) [Risks including mental health, self-harming behaviours, suicide] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief list.) [Neurodiversity, learning disability, or adjustments needed including gender preference, language difficulties, family dynamics] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief list.) [Physical health conditions including asthma, allergies, IBS] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief list.) [Medication] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else omit section entirely. Write as brief list.) Assessment (Include MEED flags for RED, AMBER or GREEN ratings by each parameter below.) Height: [Height measurement] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Weight: [Weight measurement] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Median BMI%: [BMI percentage] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Sitting BP: [Sitting blood pressure] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Pulse (sitting): [Sitting pulse] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Standing BP: [Standing blood pressure] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Pulse (standing): [Standing pulse] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Temperature: [Temperature] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Behavioural Risk Indicators [Any evidence of falsifying weight including water loading, hidden weights] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) [Micro-exercising or compulsive movement patterns] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) [Food disposal or hiding behaviours] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Legal and Safeguarding Considerations [Whether young person is Gillick competent or under parental consent] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) [Any safeguarding concerns raised during assessment] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) [Whether Mental Capacity Act or Mental Health Act relevant to this case] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Other [Any other highly relevant clinical information not otherwise covered including safeguarding concerns, trauma history relevant for medical professionals, additional context about patient or family members, legal/safeguarding considerations with prompts for capacity, consent, and escalation pathways, benefits/costs associated with admission] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, and not included anywhere else in this note or document, else leave blank.) Based on the above, this young person is currently at: Overall MEED Risk Rating: [Red / Amber / Green] (If any single RED criterion is present, overall rating is "Red". If several AMBER criteria are present, or clinical concern is high, consider overall rating "Red". If only GREEN findings and clinical concern low, rating is "Green". Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Immediate actions required: [Immediate actions such as urgent paediatrics referral, same-day bloods, inpatient consideration] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. Write as brief list.) Recommendations "Please could this young person be seen in A&E for a physical health assessment using MEED." [Date and details of next review in clinic with CAMHS] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) MEED Risk Assessment (For each item below, apply the RAG rating based on the criteria. If the item is not mentioned, leave blank. Colour code the relevant data red, amber, or green. Write any context for a more detailed assessment next to each parameter, including repetitions of observation and previous history for that parameter.) Weight and BMI [Weight for height percentage] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If <70%, rate as Red. If 70–80%, rate as Amber. If 80–85%, rate as Green.) [Rate of weight loss] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If >1kg/week for 2 weeks, rate as Red. If 500–999g/week, rate as Amber. If <500g/week, rate as Green.) Cardiovascular [Pulse when awake] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If <40 bpm, rate as Red. If 40–50 bpm, rate as Amber. If 50–60 bpm, rate as Green.) [Postural pulse change] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If >30 bpm increase, rate as Red. If <30 bpm, rate as Amber. If no significant change, rate as Green.) [Blood pressure systolic/diastolic] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If <0.4th centile, rate as Red. If postural drop >15 mmHg systolic or >10 mmHg diastolic, rate as Amber. If <2nd centile, rate as Green.) [Syncope episodes] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If recurrent, rate as Red. If occasional, rate as Amber. If dizziness only, rate as Green.) Hydration and Fluid Intake [Fluid intake] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If refusal or >10% dehydration, rate as Red. If severe restriction or 5–10% dehydration, rate as Amber. If mild restriction or <5% dehydration, rate as Green.) Temperature [Temperature] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If <35.5°C, rate as Red. If <36°C, rate as Amber. If >36°C, rate as Green.) Nutrition and Intake [Daily calorie intake] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If <500 kcal/day for 2+ days, rate as Red. If <50% required intake, rate as Amber. If moderate restriction, rate as Green.) [Food refusal] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If acute refusal, rate as Red. If severe restriction, rate as Amber. If moderate restriction, rate as Green.) Biochemical Abnormalities [Electrolytes, glucose, albumin, WCC, Hb] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If any significant abnormality including low phosphate, potassium, calcium, sodium, glucose, albumin, WCC, Hb <10, rate as Red. If comorbid diabetes risk, include instructions to escalate if insulin manipulation is suspected, insulin omission, risk of DKA, electrolyte shifts during refeeding.) SUSS Test Score [SUSS score] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If 0–1, rate as Red. If 2, rate as Amber. If 3, rate as Green.) Exercise Behaviour [Exercise level] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If >2h/day, rate as Red. If >1h/day, rate as Amber. If <1h/day, rate as Green.) [Micro-exercising if present] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Purging Behaviour [Frequency and type of purging] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If daily purging, rate as Red. If vomiting/laxatives, rate as Amber. If bingeing, rate as Green.) [Falsifying weight including water loading, weights, food disposal or hiding] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) Psychiatric Risk [Self-harm or suicidal ideation] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If moderate–high risk, rate as Red. If occasional thoughts, rate as Amber. If none, rate as Green.) Other Clinical Concerns [ECG abnormalities] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If Long QT or other significant findings, rate as Red.) [Physical struggles with carers over nutrition] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. If present, rate as Red. If occasional, rate as Amber. If none, rate as Green.) Family/Carer Dynamics [Family anxiety] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) [Disagreements over treatment] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) [Need for psychoeducation and support] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank.) [Family/carer involvement and support plan] (Only include if explicitly mentioned in transcript, contextual notes, or clinical note, else leave blank. Include in "Plan and Next Steps" section.)