Common Anal Conditions · Version 2.0
Appendix E — SBAR Handover Templates
Dr. Tamer Rushdy Elalfy · 4 min read
In this chapter
- E.1 Suspected perianal abscess
- E.2 Suspected Fournier’s gangrene
- E.3 Post-banding pelvic sepsis
- E.4 Delayed post-banding haemorrhage
- E.5 Rectal prolapse requiring reduction
- E.6 Faecal impaction with suspected perforation
- E.7 Suspected anal cancer
- E.8 Severe rectal bleeding with haemodynamic instability
Replace bracketed text. End every call with a time-bound request and record the time and response.
E.1 Suspected perianal abscess
| Suggested wording |
|---|
| S | “I am calling about [patient], [age], with [x] days of worsening perianal pain.” |
| B | “[Diabetes / immunosuppression / previous abscess]. No drainage yet.” |
| A | “Temperature [x] °C, HR [x]; tender red induration at the [quadrant] perianal margin; cannot sit.” |
| R | “Please review within [1–2] hours for same-day drainage.” |
| 🚨 Escalate immediately if | Temperature above 38.0 °C with HR > 110/min, spreading redness, skin discoloration, crepitus, or systolic BP ≤ 100 mmHg. |
E.2 Suspected Fournier’s gangrene
| Suggested wording |
|---|
| S | “I am concerned this patient has Fournier’s gangrene.” |
| B | “[Age]; diabetic on [SGLT2 inhibitor]; perineal pain for [x] hours.” |
| A | “Pain out of proportion; [dusky skin / crepitus]; HR [x], BP [x], lactate [x]. Redness has spread beyond the marked line in [x] minutes.” |
| R | “Please attend now and inform theatre; I am starting the sepsis bundle.” |
| 🚨 Escalate immediately if | Any crepitus, hypotension, confusion, or spread beyond the marked border. |
E.3 Post-banding pelvic sepsis
| Suggested wording |
|---|
| S | “[Patient] had banding [x] days ago and has worsening pain, fever, and difficulty passing urine.” |
| B | “Banding on [date]; [antithrombotics].” |
| A | “Temperature [x] °C, HR [x], BP [x]; bladder scan [x] mL.” |
| R | “Please review immediately — I suspect pelvic sepsis; cultures taken, antibiotics prescribed per protocol.” |
| 🚨 Escalate immediately if | Any combination of worsening pain, temperature above 38.0 °C, and urinary difficulty. |
E.4 Delayed post-banding haemorrhage
| Suggested wording |
|---|
| S | “[Patient], [x] days after banding, is passing fresh blood and clots.” |
| B | “Banding on [date]; restarted [anticoagulant/antiplatelet] on [date].” |
| A | “[x] pads in [x] hours; HR [x], BP [x]; Hb [x] (baseline [x]).” |
| R | “Please review within 15–30 minutes; FBC, coagulation, and crossmatch sent.” |
| 🚨 Escalate immediately if | HR > 110/min, systolic BP < 100 mmHg, more than 1 pad per hour, or Hb fall ≥ 20 g/L. |
E.5 Rectal prolapse requiring reduction
| Suggested wording |
|---|
| S | “[Patient] has a prolapsed rectum that has not reduced.” |
| B | “Out for [x] hours; previous episodes [yes/no].” |
| A | “Concentric folds; mucosa [pink / dusky / black]; abdomen [soft / tender].” |
| R | “Please review within [30–60] minutes; analgesia given; sugar ready if viable.” |
| 🚨 Escalate immediately if | Dusky, grey, or black mucosa; peritonism; failed reduction. |
E.6 Faecal impaction with suspected perforation
| Suggested wording |
|---|
| S | “[Patient] with impaction now has abdominal pain and fever.” |
| B | “[Opioids / immobility]; last bowel movement [x] days ago.” |
| A | “Temperature [x] °C, HR [x]; abdomen [distended / guarding]; lactate [x].” |
| R | “Please review now; enema withheld; CT requested.” |
| 🚨 Escalate immediately if | Peritonism, hypotension, rising lactate. |
E.7 Suspected anal cancer
| Suggested wording |
|---|
| S | “I am referring [patient] with a suspected anal cancer.” |
| B | “[Risk factors: HIV, prior HPV disease, smoking]; symptoms for [x] weeks; previous treatments.” |
| A | “[x] cm indurated ulcer at the [quadrant] anal margin, [x] cm from the verge; inguinal nodes [yes/no].” |
| R | “Please see on the suspected-cancer pathway within 2 weeks for biopsy.” |
| 🚨 Escalate immediately if | Heavy bleeding, obstruction, or abscess around the tumour. |
E.8 Severe rectal bleeding with haemodynamic instability
| Suggested wording |
|---|
| S | “[Patient] has ongoing large-volume rectal bleeding and is unstable.” |
| B | “[Anticoagulant]; [cardiac history]; [previous bleeding].” |
| A | “HR [x], BP [x], shock index [x]; Hb [x]; [x] units given.” |
| R | “Please attend now; I suggest CT angiography and interventional radiology involvement.” |
| 🚨 Escalate immediately if | Shock index > 1 after resuscitation, systolic BP < 90 mmHg, or ongoing bleeding. |
