Key elements are written in red, with bold and italics.

I – Hello Dr Consultant my name is ___, and I am a JMO in ED.

S – I have an 8-year-old girl with suspected DKA brought in by her parents with reduced consciousness, on a background of one month of polyuria, polydipsia and rapid weight loss. Reported dysuria for a few days. She woke with nausea, vomiting and abdominal pain this morning and became progressively fatigued throughout the day.

B – She has no relevant past medical or social history; she has a family history of diabetes, coeliac disease. On examination she was drowsy and confused and showed signs of moderate to severe dehydration. She was tachycardic and tachypnoeic with a BSL of 29, pH of 7.0 and ketones, glucose, WBC, and nitrites in her urine.

A – My assessment is this is DKA due to a first presentation of T1DM, with coexistent UTI.

R – I recommend she be reviewed by a senior doctor urgently, have continuous close monitoring of vital signs. She should be started on IV rehydration and subsequently insulin pending review by a senior doctor.

Needed to win

Need to include all 5 sections of ISBAR, plus mention at least four of the following:

1. Background of polyuria, polydipsia, weight loss for one month.
2. At least 3 out of the 5 signs/symptoms (nausea/vomiting, drowsiness/confusion/non-collaborative, dehydration, tachycardia, tachypnoea).
3. BSL 29mmol/L and pH 7.0.
4. Diabetic ketoacidosis
5. Urgent review by senior doctor.