Key EMT mnemonics

The frameworks the questions are built on.

Quick reference for the core frameworks used throughout patient assessment and the NREMT cognitive exam.

SAMPLE History

Structuring a patient's medical history
SSigns/Symptoms — what's wrong, subjective and objective
AAllergies — medications, foods, environmental
MMedications — current prescriptions and OTC drugs
PPertinent past medical history — relevant prior conditions
LLast oral intake — food/drink, timing
EEvents leading up to the incident

OPQRST

Characterizing a symptom in detail, especially pain
OOnset — sudden or gradual, what the patient was doing
PProvocation/Palliation — what makes it better or worse
QQuality — sharp, dull, crushing, burning, etc.
RRadiation — does it spread anywhere else
SSeverity — often rated on a 1-10 scale
TTime — how long it's been going on, any change over time

AVPU

Quick level-of-consciousness scale
AAlert — spontaneously aware and responsive
VVerbal — responds to voice, not spontaneously alert
PPain — responds only to a painful stimulus
UUnresponsive — no response to voice or pain

DCAP-BTLS

What to look/feel for during a trauma exam of any body region
DDeformities
CContusions
AAbrasions
PPunctures/Penetrations
BBurns
TTenderness
LLacerations
SSwelling

Cincinnati Prehospital Stroke Scale

Fast field stroke screen — any one abnormal finding is a positive screen
Facial droop — ask the patient to smile
Arm drift — ask the patient to hold both arms out, eyes closed
Speech — ask the patient to repeat a phrase, listen for slurring

Rule of Nines (Adult)

Estimating burn size as a percentage of total body surface area
Head — 9%
Each arm — 9%
Chest/abdomen (front torso) — 18%
Back (posterior torso) — 18%
Each leg — 18%
Groin — 1%

Scene Size-Up Components

What to establish before patient contact
BSI/standard precautions
Scene safety
Mechanism of injury / nature of illness
Number of patients and need for additional resources

FAST

Public-facing stroke screen, commonly used alongside the Cincinnati scale
FFace — ask the patient to smile, look for drooping on one side
AArms — ask the patient to raise both arms, look for one drifting down
SSpeech — ask the patient to repeat a phrase, listen for slurred or strange speech
TTime — note the time symptoms started (or last known well) and get the patient to definitive care fast

AEIOU-TIPS

Differential for altered mental status — reviewing this list on scene can jog a cause that isn't obvious
AAlcohol
EEpilepsy/Seizure (including postictal state)
IInsulin — hypo- or hyperglycemia
OOverdose (or Oxygen — hypoxia)
UUremia (kidney failure/toxin buildup)
TTrauma (especially head injury) or Temperature (hyper-/hypothermia)
IInfection
PPsychiatric
SStroke (or Shock, Space-occupying lesion)

CUPS

Rapid one-word patient priority classification for radio reports and transport decisions
CCritical — immediate life threat, load-and-go
UUnstable — significant problem, high risk of deterioration
PPotentially unstable — stable now, but with a concerning finding or mechanism
SStable — no significant threat identified

RPM

The 30-second per-patient check used in START (Simple Triage And Rapid Treatment) mass-casualty triage
RRespirations — absent (reposition airway once; still absent = deceased/expectant), or present but >30/min = immediate
PPerfusion — radial pulse absent, or capillary refill >2 sec = immediate
MMental status — unable to follow simple commands = immediate

Glasgow Coma Scale

Scoring level of consciousness — three components summed for a total of 3-15
Eye opening (1-4) — 4 spontaneous, 3 to voice, 2 to pain, 1 none
Verbal response (1-5) — 5 oriented, 4 confused, 3 inappropriate words, 2 incomprehensible sounds, 1 none
Motor response (1-6) — 6 obeys commands, 5 localizes pain, 4 withdraws from pain, 3 abnormal flexion, 2 abnormal extension, 1 none
A score of 8 or less is widely used as the threshold for a severely depressed level of consciousness and airway concern.

Rule of Nines (Pediatric)

Burn size estimation in infants/children — proportionally different from the adult figures above because a child's head is relatively larger and legs relatively shorter
Head — 18%
Each arm — 9%
Chest/abdomen (front torso) — 18%
Back (posterior torso) — 18%
Each leg — 13.5%
Groin — 1%

Rule of Palm

Quick estimate for small or scattered/patchy burns, where the rule of nines' large regions don't fit well
The patient's own palm (including fingers) is approximately 1% of their total body surface area — use it as a measuring stick against the burned area(s).

PERRL

Documenting a normal pupil exam
PPupils
EEqual — in size
RRound
RReactive — constrict appropriately
Lto Light
Unequal pupils (anisocoria) can be a normal variant in some people, but in the setting of trauma or altered mental status it raises concern for increased intracranial pressure.