Safe Medical Referrals in the ED

Communication failures drive a large share of sentinel events in hospitals. Safe Medical Referrals in the ED closes that gap — a practical, evidence-based guide for emergency physicians, registrars, and SHOs who need to make high-stakes referral decisions confidently, correctly, and safely.

What sets this guide apart

• Structured referral mastery with SBAR & iSoBAR — exact phone scripts and handover sequences that reduce ambiguity at critical moments.
• Specialty-specific pathways for Cardiology, Neurology/Neurosurgery, Surgery, Respiratory, Psychiatry, and Geriatrics, with time-thresholded escalation criteria.
• Validated scoring tools built in — GRACE, NIHSS, Alvarado, Glasgow-Blatchford, Wells, C-SSRS, and the Clinical Frailty Scale.
• Safety nets and handover scripts — checklists, escalation ladders, and discharge frameworks that protect patients post-referral.
• Guideline-anchored — aligned with ESC, NICE, BTS, AHA, and RCEM 2025.
• Medico-legal clarity — guidance for declined referrals, capacity frameworks, and documentation that holds up.

Contents at a glance

• 11 chapters covering core ED referral domains
• 20+ real clinical cases with full outcomes
• Specialty-by-specialty criteria with time thresholds
• Tear-out checklists, SBAR scripts, and urgency guides by specialty

Who it's for

• Emergency physicians, SHOs, and registrars making referrals under pressure
• Interns and foundation doctors starting on-call
• Medical students on emergency and acute medicine rotations
• UK and Irish clinicians — direct relevance to RCEM, the Mental Health Act, and RSA driving rules

Format & access

Instant PDF download. Readable on any device, printable, yours to keep. First Edition 2025, published by the MedSprint Clinical Editorial Board.