What extra information should a Pediatric SBAR include compared to adult units?

Pediatric SBARs need weight-based dosing verification, developmental stage context, parent/guardian involvement and understanding, feeding tolerance specifics (especially for infants), and age-appropriate pain assessment scales (FLACC for pre-verbal, Wong-Baker FACES for younger children). Always include the child's weight in kg since every medication dose depends on it.

How do I document parent involvement in a Peds SBAR handoff?

Include parent names, who has been present, their understanding of the plan, any teaching that was done, and their emotional state. Parents are part of the care team in pediatrics — the incoming nurse needs to know if mom is anxious and needs extra explanation, if dad is the primary contact overnight, or if there are custody or language considerations.

Should I use different pain scales in Pediatric SBAR reports?

Yes. Always specify which pain scale you used and why. FLACC (Face, Legs, Activity, Cry, Consolability) for ages 0-3 or pre-verbal children. Wong-Baker FACES for ages 3-7. Numeric 0-10 for children 8 and older who can self-report. Document the scale used so the incoming nurse continues with the same assessment method.

Pediatric SBAR Example: Peds Nursing Handoff

Pediatric nursing handoffs carry a unique challenge: the patient often cannot self-report, medication dosing is weight-dependent, and the family is an active part of the care plan. A strong Peds SBAR addresses all three — clinical status, precise dosing, and parent dynamics — so the incoming nurse walks in with a complete picture.

The example below covers bronchiolitis in a 4-year-old, one of the most common winter admissions on a Peds floor. Notice how weight, developmental context, and family communication are woven throughout every section.

SBAR Example: 4-Year-Old with Bronchiolitis

Situation

Lily Chen, room 214 bed A, 4-year-old female, weight 16.2kg, admitted yesterday for RSV bronchiolitis with moderate respiratory distress. Reporting end-of-day-shift handoff. She has improved today — weaned from high-flow nasal cannula to regular nasal cannula this afternoon. Taking PO fluids better, though still refusing most solid food. Mom (Jennifer) has been at bedside all day and is comfortable with the plan. Dad will be here overnight.

Background

PMH: born at 36 weeks (late preterm), resolved neonatal jaundice, recurrent otitis media (3 episodes in past year), no prior hospitalizations. Immunizations UTD. Home meds: none. Allergies: NKDA. Developmentally appropriate — speaks in full sentences, attends preschool. Older sibling (7yo) had URI symptoms last week. IV: 22g R hand (placed in ED, site clean, flushes well). RSV rapid antigen positive on admission. CXR admission: bilateral perihilar peribronchial thickening, no consolidation. No antibiotics — viral illness. Started on 2L high-flow NC in ED, weaned to 1L regular NC at 1400 today. Maintenance IVF D5 1/2 NS + 20 KCl at 55mL/hr (running since admission, decreased from 65mL/hr this AM as PO intake improved).

Assessment

VS: HR 118 (age-appropriate, down from 140s on admission), RR 28 (was 42 yesterday), T 99.4 (trending down from 101.8 last night), BP 92/58, SpO2 95-96% on 1L NC (desats to 91-92% when NC removed for more than 2 minutes). Mild subcostal retractions still present but no nasal flaring or accessory muscle use. Lung sounds: transmitted upper airway sounds bilaterally, scattered expiratory wheezes R > L, improved air entry compared to this AM. Suctioned nasally x2 this shift — moderate clear to white secretions. FLACC pain score 0 at rest. Oral intake: drank approximately 400mL Pedialyte and apple juice today, ate 4 crackers and half a popsicle. Refused chicken nuggets at dinner. Last wet diaper 1530, adequate output. IV site R hand — no redness, swelling, or infiltration. Mood: playful this afternoon, watched tablet, colored with mom. Cried briefly during nasal suctioning but consoled quickly.

Recommendation

Continue 1L NC overnight — do NOT attempt to wean to room air until morning, per Dr. Patel. If SpO2 drops below 92% sustained on 1L, go back to 2L and notify resident. Nasal suctioning PRN before feeds and when audibly congested — she tolerates it better if you let her hold the suction tubing first (mom's tip). Encourage PO fluids overnight — she prefers apple juice over Pedialyte, drinks better from a straw cup (mom brought one from home, it's on the bedside table). If PO intake drops below 200mL overnight, keep IVF running. If she's drinking well, IVF can be decreased to 40mL/hr. RT assessment at 2200 and 0200. Discharge criteria discussed with family: needs 12 hours on room air with SpO2 above 94%, adequate PO intake, and no increased work of breathing. Earliest discharge likely tomorrow afternoon if wean goes well in the morning. Dad arriving at 2000 — mom will brief him. He is quieter but asks good questions, may need you to check in with him directly.

What Makes This Peds SBAR Effective

Several details in this report are specific to pediatric nursing. The weight is stated upfront because every dose calculation depends on it. The developmental context (speaks in sentences, attends preschool) helps the incoming nurse set expectations for interaction. The family dynamics are specific: mom is comfortable, dad is arriving and may need direct communication. Even the detail about the straw cup and the suction tubing trick — these are the kind of practical notes that make a night shift run smoothly.

The Recommendation section gives clear wean parameters (don't wean overnight, specific SpO2 thresholds for escalation) and discharge criteria, so the night nurse can assess progress without waking the resident for routine questions.

Record Your Peds Handoff in Seconds

Pediatric handoffs have a lot of moving parts — respiratory support, feeding, family dynamics, developmental context. ShiftSBAR's voice recorder captures everything you say and sorts it into the right SBAR sections, including family details and age-appropriate clinical context.