VUMC's List of Interesting Emergency Medicine Mnemonics

Acute Rheumatic Fever:

There are several for the major criteria, I use "JONES"

J - Joints
O - Obvious (cardiac) - sorry, I know this is kinda weak
N - Nodules (subcutaneous nodules)
E - Erythema marginatum
S - Syndeham's Chorea


Ossification centers of the elbow:

There are two that I know of (most people use "CRITOE"):

C - Capitellum
R - Radial head
I - Internal (medial epicondyle)
T - Trochlea
O - Olecranon
E - External (lateral epicondyle)

These appear at 2, 4, 6, 8, 10, and 12 years of age in order and go away two years later.
The other mnemonic I know for the ossification centers is "Come Rub My Tree Of Love" where the "M" is medial epicondyle and the "L" is the lateral epicondyle.


Rat Poisons:

"RATS PANIC" I'm sure that you'll easily remember this one!

R - Red squill
A - Arsenicals
T - Thallium
S - Strychnine

P - PNU/Phosphorus/zn Phosphide
A - Alpha naphtha thiurea (ANTU)
N - Norbormide
I - Indanediones
C - Coumadin/cholcalciferol

From: Jack Snyder, MD, JD via EM News


Causes of ST Elevation:

"ELEVATION"

E - Electrolytes
L - LBBB
E - Early Repolarization
V - Ventricular hypertrophy
A - Aneurysm
T - Treatment - Pericardiocentesis
I - Injury (AMI, contusion)
O - Osborne waves (hypothermia)
N - Non-occlusive vasospasm


Altered Mental Status:

"AEIOU TIPS"

A - Alcohol/drugs
E - Endocrine
I - Insulin
O - Opiates
U - Uremia

T - Toxins/trauma
I - Infections
P - Psych/porhyria
S - SAH, shock, stroke, seizure, space occupying lesion


Non-Cardiogenic Pulmonary Edema:

"PONS"

P - Phosgene, paraquat, phenothiazines
O - Opioids/organophosphates
N - Nitrous dioxide
S - Salicylates


Anion Gap Acidosis:

"Mudpiles"

M - Methanol
U - Uremia
D - DKA/AKA
P - Paraldehyde/phenformin
I - Iron/INH
L - Lactic acidosis
E - Ethylene glycol
S - Salicylates


Normal Gap Acidosis:

"HARDUP"

H - Hyperalimentation/hyperventilation
A - Acetazolamide
R - RTA
D - Diarrhea
U - Ureteral diversion
P - Pancreatic fistula/parenteral saline


Osmolar Gaps:

"ME DIE"

M - Methanol
E - Ethanol

D - Diuretics (mannitol, sorbitol, glycerol)
I - Isopropanol
E - Ethylene glycol


Cholinergic OD:

"SLUDGE"

S - Salivation
L - Lacrimation
U - Urination
D - Diarrhea
G - Gastric upset
E - Emesis

or, alternatively:

"Dumbbels"

D - Diarrhea
U - Urination
M - Miosis/muscle weakness
B - Bronchorrea
B - Bradycardia
E - Emesis
L - Lacrimation
S - Salivation/ sweating


Anticholinergic OD:

Not really a mnemonic:

Blind as a bat
Dry as a bone
Red as a beet
Mad as a hatter
Hot as a hare
and: mydriasis, absent BS, urinary retention


Concretions:

"Big Mess"

B - Barbituates
I - Iron
G - Glutethemide

M - Meprobamate
E - Extended release theophylline
SS - Salicylates


Radiopaque Ingestants:

"Chipes"

C - Cocaine condoms/ chloral hydrate/ calcium
H - Heavy metals
I - Iron/ iodides
P - Psychotropics (TCA, phenothiazines)
E - Enteric coated/BA
S - Solvents (CCl4)


Suicide Risk Factors:

"Sad Persons"

S - Sex (male)
A - Age (young/elderly)
D - Depression

P - Previous attempts
E - ETOH
R - Reality testing
S - Social support
O - Organized plan
N - No spouse
S - Sickness

0 - 2 = home with f/u
3 - 4 = close f/u, +/- hosp
5 - 6 = ++ hosp, +/- f/u
7 - 10 = +++ hosp/commit


Henoch-Schonlein Purpura:

"JARS"

J - Joints
A - Abdominal pain
R - Renal
S - Skin


Wrist Bones:

"Never Loosen Tillies Pants, Mother Might Come Home"

Proximal row:
N - Navicular
L - Lunate
T - Triquetrium
P - Pisiform

Distal row:
M - greater Multiangular (trapezium)
M - lesser Multiangular (trapezoid)
C - Capitate
H - Hamate

Also: "Some Lovers Try Positions That They Can't Handle"


Rotator Cuff Muscles:

"SITS"

S - Supraspinatus
I - Infraspinatus
T - Teres minor
S - Subscapularis


The Salter Classification:

"SALTR"

S - Slip of physis
A - Above physis
L - Lower than physis
T - Through physis
R - Rammed physis


Anterior Mediastinal Mass:

"4 T's"

T - Thymoma
T - Teratoma
T - Thyroid tumor/goiter
T - Terrible lymphoma


Middle Mediastinal Mass:

"Habit5"

H - Hhernia, hematoma
A - Aneurysm
B - Bronchogenic cyst/duplication cyst
I - Inflammation (sarcoid, histo, coccidio, TB)
T5 - Tumors (lung, lymphoma, leukemia, leiomyoma, lymph node hyperplasia)


Bilateral Hilar Adenopathy:

"Please Helen Lick My Popsicle Stick"

P - Primary TB
H - Histoplasmosis
L - Lymphoma
M - Metastases
P - Pneumoconiosis
S - Sarcoidosis


Small Bowel Obstruction:

"SHAVIT"

S - Stone (gallstone ileus)
H - Hernia
A - Adhesions
V - Volvulus
I - Intussusception
T - Tumor


Hypercalcemia:

"SHAMPOO DIRT"

S - Sarcoidosis
H - Hyperparathypoidism, Hyperthyroidism
A - Alkali-milk syndrome
M - Metastases, myeloma
P - Paget disease
O - Osteogenesis imperfecta
O - Osteoporosis

D - Vitamin intoxication
I - Immobility
R - RTA
T - Thiazides


Tumors that go to bone:

"Kinds Of Tumors Leaping Primarily To Bone"

K - Kidney
O - Ovarian
T - Testicular
L - Lung
P - Prostate
T - Thyroid
B - Breast

Submitted by Frank Birinyi, M.D.


Syncope:

"HEAD, HEART and VESS'LS"

H - hypoglycemia hypoxia
E - epilepsy
A - anxiety [the "swoon"]
D - dysfunction of brain stem [i.e. brain stem TIA]

H - heart attack
E - embolism of pulmonary artery
A - aortic obstruction [ Aortic stenosis, myxoma, IHSS ]
R - rhythm disturbance
T - tachycardia esp VT

V - vasovagal
E - ectopic i.e. hemorrhage obvious or not
S - situational [micturation, defecation...]
S - subclavial steal
L - low SVR [eg: anaphalaxis]
S - sensitive carotid sinus

Submitted by Bill Young, M.D.


Endocarditis:

"FAME"

F - FEVER
A - ANEMIA
M - MURMUR =

E - ENDOCARDITIS

Submitted by Tag Filley, M.D.


Eosinophilia:

"NAACP"

N - Neoplasm
A - Allergy
A - Addison's
C - Cirrhosis, CVD
P - Parasite (visceral larva migrans), Periarteritis nodosa

Submitted by Tag Filley, M.D.


Asystole:

"3 Hypo's &;3 Hyper's"

Hypoxia
Hypothermia
Hypokalemia

Hyperkalemia
Hyper H+ (Acidosis)
Hyper Rx (Drugs/OD)

Submitted by Tag Filley, M.D.


Causes of PEA

"Hey, Hey, Hey! THAT's EMD!"

H-hypovolemia
H-hypoxia
H-hypothermia
T-tamponade (cardiac)
H-hyperkalemia
A-acidosis
T-tension pneumothorax
s
E-embolism (pulmonary)
M-myocardial infarction
D-drug overdose

Submitted by Stephanee Woods


Depression:

"SIGECAPS"

S Sleep (increases/decreases)
I Interest/Hobbies decrease
G Guilt/Worthlessness
E Energy decreases
C Concentration decreases
A Appetite (increases/decreases)
P Phychomotor movements
S Suicidal ideations

Submitted by Tag Filley, M.D.


Hypoglycemia:

"Reexplain"

R - renal failure
EX - exogenous
P - pituitary
L - liver failure
A - alcohol
I- insulinoma/infection
N - neoplasm


Kawasaki's:

"scream fever"

S - sausage fingers
C - conjunctival redness
R - rash
E - extremity involvement
A - adenopathy
M - mucosal erythema
FEVER - fever


Compartment Syndrome:

"6 p's"

pulselessness
pain
pallor
parasthesia
poikiolothermia
paralysis


Drugs that can go into an ET tube:

"lane"

L - lidocaine
A - atropine
N - naloxone
E - epi

Some like NAVEL, which includes Valium. Others have commented that valium should not go in an ET tube.


History taking in EMS:

"sample"

S - signs/symptoms
A - allergies
M - medications
P - past medical history
L - last oral intake
E - events leading to injury or illness
submitted by wharpel@kuntrynet.com


Level of consciousness:

"avpu"

A - alert
V - resonds to verbal stimuli
P - responds to painful stimuli
U - unconscious
submitted by wharpel@kuntrynet.com


Pain scale:

"OPQRST"

O - onset
P - provocation
Q - quality
R - radiation
S - severity
T - time
submitted by wharpel@kuntrynet.com

Pain Scale (Revisited)

PQRSTAPPP

P - palliates/provokes
Q - quality
R - region/radiation
S - severity (on a 1-10 scale)
T - timing (onset, frequency, duration)
A - associated symptoms
P - prior
P - persists
P - progression (stable, better, worse)
Submitted by Omar A. Blanco


More on Pain Evaluation
LOCI" (Latin for places) and the "Daughters of the American Revolution"

L - Location
O- Onset
C- Character
I- Intensity

D- Duration
A- Aggravation
A- Alleviation
A - Association
R - Radiation

Submitted by John Loraditch M.D.


One More Pain Mnemonic

P - period of pain
A - area of pain
I - intensity of pain
N - nullify ( what makes pain go away, if any)

Submitted by Greg Van Hook


Steps for KED application:

"My Baby Looks Hot Tonight."

M stands for middle strap
B stands for bottom strap
L stands for Legs
H stands for head
T stands for top strap

submitted by rwhiddon@surfsouth.com


Microcytic Anemia:

"TICS"-

Thallasemia
Iron deficiency
Chronic disease
Sideroblastic anemia

Submitted by Jeff Rodgerson M.D.
HCMC Medical Center


Criteria for Lupus

SOAP BRAIN MD

Serositis (pleuritis, pericarditis)
Oral Ulcers
Arthritis
Photosensitivity

Blood (all are low - anemia, leukopenia, thrombocytopenia)
Renal (protein)
ANA
Immunologic (DS DNA etc.)
Neurologic (psyc, seizures)

Submitted by Mike Ritter, MD FAAEM, San Diego, CA


Non-GI Causes of Vomiting

ABC's of Non- GI causes of vomiting

Acute renal failure
Brain (Increased ICP)
Cardiac (Inferior MI)
DKA
Ears (labyrinthitis)
Foreign substances (Tylenol, theo, etc)
Glaucoma
Hyperemesis Gravidarum
Infections (pyelonephritis, meningitis)

Submitted by : Mike Ritter, MD FAAEM, San Diego, CA


Causes of Pancreatitis

BAD SHIT

Black scorpion bite
Alcohol
Drugs (tetracycline, azothioprin, sulfa)

Stones (gallstones)
Hyperlipidemia
Idiopathic
Trauma

Submitted by : Mike Ritter, MD FAAEM, San Diego, CA


Shortness of Breath

HAPISOCS

H: History of any pulmonary disease
A: Activity at onset
P: Pain upon inspiration
I: Infections fever/chills
S: Smoker years/packs
O: Orthopnea
C: Cough (Persistent)
S: Sputum Productive/color

Submitted by medmanRRT@aol.com


Organisms that Spread from Blood to Urine

CASH CML

C - candida
A - aureus staph
S - salmonella
H - histoplasma
C - cytomegalo virus
M - mycobacteria
L - leptospira

Submitted by Ousama Dabbagh M.D


Vertebral/Basilar Ischemia

4Ds

dizziness (nystagmus)
diplopia (skew deviation)
dysarthria
dysphagia

Submitted by: Ronald H. Miller, OD, The Ohio State University


Last updated, Tuesday, 23 December, 1997
If you know any good mnemonics or have any comments, please send e-mail to seth.wright@mcmail.vanderbilt.edu