Student should attempt an SBARR calling neurology or neurosurgery registrar and cover the following:

• Introduce themselves
• Situation: “I have a 75-year-old patient with a fall and head injury who is on warfarin and now presents with confusion and a mild headache. GCS is currently 14.”
• Background: “The patient briefly lost consciousness after the fall. They have a history of hypertension and atrial fibrillation and are anticoagulated.”
• Assessment: “Vital signs are stable, but we are seeing a mild drop in GCS and signs that could indicate intracranial injury. Urgent non-contrast CT head is pending/requested.”
• Recommendation and Review: “I’m seeking advice on further management, and I believe they may need to be reviewed for potential intracranial bleed and reversal of anticoagulation via PCC/ IV Vit K/ FFP.”

REASSESS the patient after all interventions, ensure they are stable before moving on to the next!

• Expected for them to at least check on SpO2 in case it drops (Due to complications mentioned in B: Breathing)

Things you might want to highlight during the feedback:

• If airway is compromised and there is a concern for spinal injury: AVOID head tilt chin lift manoeuvre, go for jaw thrust, OPA.
• Signs of basal skull fracture: CSF from nose or ear, raccoon eyes, battle sign, haemotympanum