Saturday, August 15, 2015

Emergency Medicine Mnemonics

Emergency Medicine Mnemonics


Kendrick Extrication Device (K.E.D.): order of placing straps
"MBaby Looks Hot Tonight":
Middle
Bottom
Legs
Head
Top
· Note: K.E.D. is a device used to extract patients out of a crashed car or
similar tight space.

Seizure: quick history taking FACT:
Focus: generalized vs. local activity
Activity: tonic-clonic vs. absence
Color: red, blue, ashen--possible indicator of hypoxia
Time: length of seizure


Asthma acute attack: 5 life threatening signs SHOCK:
Silent chest
Hypotension
One third of best/predicted PFR
Cyanosis
Konfusion


Fits: causes HOWARD:
Hypertension
Obesity
Warfarin
Alcohol
Retardation
Drugs


Blackout/collapse: causes THE VESPA MC:
TIA
Hypoglycemia
Epilepsy
Vasovagal
Epilepsy
Situation
Ppostural hypotension/ PE
Arrthymia/ Aortic stenosis(HOCM)
Myocardial infarction
Carotid sinus hypersensitivity


Snakebite scoring system · 6 T's:
Toothless
T-shirt
Tattooed
Trailer park
Testosterone
Tequila (EtOH)
· One point for each positive.
· 3 or more positive T's suggests venomous bite.


Motor Vehicle Collision (MVC): Single vehicle MVC differential of
causes
 · 7 S's:
Suds (EtOH)
Suicide
Sleep
Seizure
Sugar
Stroke (bleed)
Stupidity


ARDS: diagnostic criteria ARDS:
Acute onset
Ratio (PaO2/FiO2) less than 200
Diffuse infiltration
Swan-Ganz Wedge pressure less than 19 mmHg


ARDS: full differential CARDS? HOPE ITS NOT ARDS:
CNS disorders
Aspiration (gastric)
Radiation
Drugs (heroin, morphine, barbiturates, etc)
Smoke, toxic gas inhalation
Hypotension, shock
Oxygen toxicity
Pancreatitis
Emboli
Infection, sepsis
Transfusion reaction
Surgery (esp. cardiac)
Near drowning
Obstetrical emergencies (eg eclampsia, HELLP)
Thermal injuries/ burns
Altitude sickness
Renal failure
DIC
SLE


Pneumothorax: causes SIT, 3 A's, 3 C's:
Spontaneous (often tall thin men)
Iatrogenic
Trauma
Asthma
Alveolitis
AIDS
COPD
Carcinoma
Cystic fibrosis


Coma: differential UNCONSCIOUS:
Units of insulin
Narcotics
Convulsions
Oxygen
Nonorganic
Stroke
Cocktail
ICP
Organism
Urea
Shock


Shock: general features CHORD ITEM:
Cold, clammy skin
Hypotension
Oliguria
Rapid, shallow breathing
Drowsiness, confusion
Irritability
Tachycardia
Elevated or reduced central venous pressure
Multi-organ damage


Shortness of breath: short differential AAAA PPPP:
Airway obstruction
Angina
Anxiety
Asthma
Pneumonia
Pneumothorax
Pulmonary Edema
Pulmonary Embolus


Dyspnea: differential 3A's: Three Airways: Airway
obstruction, Anaphylaxis, Asthma
3P's: Three Pulmonary's: Pneumothorax, PE, Pulmonary edema
3C's: Three Cardiacs: Cardiogenic pulmonary edema, Cardiac
ischemia, Cardiac tamponade
3M's: Three Metabolics: (DOCDKA, Organophosphates, Carbon
monoxide poisoning


Seizures: differential SICK DRIFTER:
Substrates (sugar, oxygen)
Isoniazid overdose
Cations (Na, Ca, Mg)
Kids (ecclampsia)
Drugs (CRAPCocaine, Rum (alcohol), Amphetamines,
PCP)
Rum (alchohol withdrawl)
Illnesses (chronic seizure disorder or other chronic disorder)
Fever (meningitis, encephalitis, abscess)
Trauma (epidural, subdural, intraparynchymal hemorrhage)
Extra: toxocologic (TAILTheo, ASA, Isoniazid,
Lithium) and 3 Anti's: (Antihistamine overdose, Antidepressant
overdose, Anticonvulsants (too high dilanitin, tegretol) or benzo
withdrawl.
Rat poison (organophospates poisoning)


Pneumonia: hospitalisation criteria ABCD:
Age greater than 60
Blood urea greater than 7 mmol/l
Confusion
Diastolic BP less than 60 mmHg
·Hospitalise the pneumonia patient if 2 or more of these criteria are met.


Myocardial infarction: some emergency treatment drugs 
ABCD
:
Aspirin
Beta blockers
Clot busters (thromboytics)
Dynamite (nitrates)


Malaria: complications of falciparum malaria CHAPLIN:
Cerebral malaria/ Coma
Hypoglycemia
Anaemia
Pulmonary edema
Lactic acidosis
Infections
Necrois of renal tubules (ATN)


MI: immediate treatment DOGASH:
Diamorphine
Oxygen
GTN spray
Asprin 300mg
Streptokinase
Heparin


Pain history checklist OLDER SAAB:
Onset
Location
Description (what does it feel like)
Exacerbating factors
Radiation
Severity
Associated symptoms
Alleviating factors
Before (ever experience this before)


Pulseless Electrical Activity (PEA): checklist PEA:
Pulses check
Epinepherine
Atropine


PEA/Asystole (ACLS): etiology ITCHPAD:
Infarction
Tension pneumothorax
Cardiac tamponade
Hypovolemia/ Hypothermia/ Hypo-, Hyperkalemia/ Hypomagnesmia/
Hypoxemia
Pulmonary embolism
Acidosis
Drug overdose


Trauma: motor vehicle accident considerations I AM SCARED:
Impact (head-on, rear-end, t-bone, rollover, rotational etc.)
Auto vs. pedestrian, bike, motorcycle (start @ speed >10mph)
Medical history (cardiac, coagulolation, liver, immuno, obese, prego)
Speed (>50 mph?)
Compartment intrusion (>12 inches?)
Age (<5 or >55 y.o.?)
Restraints (lap & shoulder, either, airbag, infant or child seat?)
Ejection/ Extrication (eject=25x greater death, extr>20min)
Death (at scene, same vehicle, other)


V-fib/pulseless v-tach (new ACLS as of 2001) "EVAL My
Pumper":
Epinephrine
Vasopressin
Amiodarone (class IIb--better for heart failure)
Lidocaine (indeterminate - better for young, healthy or persistent)
MgSO4 (IIb for hypomagnesemic state or torsades)
Procainamide (IIb for intermittent/recurrent VF/VT)


Asystole: treatment "Have some asystole "TEA":
Transcutaneous pacing
Epi
Atropine


JVP: raised JVP differential PQRST (EKG waves):
Pericardial effusion
Quantity of fluid raised (fluid over load)
Right heart failure
Superior vena caval obstruction
Tricuspid stenosis/ Tricuspid regurgitation/ Tamponade
(cardiac)


JVP: raised JVP: extra-cardiac causes FAT PEA:
Fever
Anaemia
Thyrotoxicosis
Pregnancy
Exercise
A-V fistula
· These are in addition to all the cardiac ones (pericardial effusion, RHF,
tricuspid stenosis, SVC obstruction, etc).


Endotrachial tube deliverable drugs O NAVEL:
Oxygen
Naloxone
Atropine
Ventolin (albuterol)
Epinephrine
Lidocaine
· If you can't get IV access established, and have necessity to administer
resuscitative meds, remember you have the airway and can give the above drugs.
· Drug delivery is enhanced if diluted with 10cc NS and rapid introduced for
aeresolization.
· Alternatively, bare bone version is ALE, as above.


Syncope causes, by system HEAD HEART VESSELS:
· CNS causes include HEAD:
Hypoxia/ Hypoglycemia
Epilepsy
Anxiety
Dysfunctional brain stem (basivertebral TIA)
· Cardiac causes are HEART:
Heart attack
Embolism (PE)
Aortic obstruction (IHSS, AS or myxoma)
Rhythm disturbance, ventricular
Tachycardia
· Vascular causes are VESSELS:
Vasovagal
Ectopic (reminds one of hypovolemia)
Situational
Subclavian steal
ENT (glossopharyngeal neuralgia)
Low systemic vascular resistance (Addison's, diabetic vascular
neuropathy)
Sensitive carotid sinus


Atrial fibrillation: causes of new onset THE ATRIAL FIBS:
Thyroid
Hypothermia
Embolism (P.E.)
Alcohol
Trauma (cardiac contusion)
Recent surgery (post CABG)
Ischemia
Atrial enlargement
Lone or idiopathic
Fever, anemia, high-output states
Infarct
Bad valves (mitral stenosis)
Stimulants (cocaine, theo, amphet, caffeine)


Neurological focal deficits 10 S's:
Sugar (hypo, hyper)
Stroke
Seizure (Todd's paralysis)
Subdural hematoma
Subarachnoid hemorrhage
Space occupying lesion (tumor, avm, aneurysm, abscess)
Spinal cord syndromes
Somatoform (conversion reaction)
Sclerosis (MS)
Some migraines


Miosis: causes of pin-point pupils CPR ON SLIME:
Clonidine
Phenothiazines
Resting (deep sleep)
Opiates
Narcotics
Stroke (pontine hemorrhage)
Lomotil (diphenoxylate)
Insecticides
Mushrooms/ Muscarinic (inocybe, clitocybe)
Eye drops


Meningicoccal meningitis: complications SAD REP:
Sepsis/ Shock/ Subdural effusion
Ataxia/ Abscess (brain)
DIC/ Deafness
Retardation
Epilepsy
Paralysis


Activated charcoal: contraindications CHEMICAL CamP:
Cyanide
Hydrocarbons
Ethanol
Metals
Iron
Caustics
Airway unprotected
Lithium
CAMphor
Potassium


Ipecac: contraindications 4 C's:
Comatose
Convulsing
Corrosive
hydroCarbon


Organophosphates poisoning: symptoms DUMBBELS:
Diarrhea
Urination
Miosis
Bradycardia
Bronchospasm
Emesis
Lacrimation
Salivation


Coma and signicantly reduced conscious state causes: causes
COMA:
CO2 and CO excess
Overdose: TCAs, Benzos, EtOH, insulin, paracetamol, etc.
Metabolic: BSL, Na+, K+, Mg2+, urea, ammonia, etc.
Apoplexy: stroke, SAH, extradural, subdural, Ca, meningitis,
encephalitis, cerebral abscess, etc.


Chest pain: differential CHEST PAIN:
Costochondritis/ Cocaine abuse
Herpes zoster/ Hyperventilation
Esophagitis/ Esophageal spasm
Stenosis (AS)
Trauma
PE/ Pneumonia/ Pneumothorax/ Pericarditis/ Pancreatitis
Angina/ Aortic dissection/ Aortic anerusym
Infarction/ IV disk disease
Neuropsychiatric disorders (e.g. depression, Da Costa's)


Ventricular fibrillation: treatment "Shock, Shock, Shock,
Everybody Shock, Little Shock, Big Shock, Momma Shock, Poppa Shock":
Shock= Defibrillate
Everybody= Epinephine
Little= Lidocaine
Big= Bretylium
Momma= MgSO4
Poppa= Pocainamide


Fall: potential causes I'VE FALLEN:
Illness
Vestibular
Environmental
Feet/ Footwear
Alcohol and drugs
Low blood pressure
Low O2 states
Ears/ Eyes
Neuropathy


RLQ pain: differential APPENDICITIS:
Appendicitis/ Abscess
PID/ Period
Pancreatitis
Ectopic/ Endometriosis
Neoplasia
Diverticulitis
Intussusception
Crohns Disease/ Cyst (ovarian)
IBD
Torsion (ovary)
Irritable Bowel Syndrome
Stones


Decompression sickness Boyle's law: volume of gas is
inversely proportionate to its pressure.
· Therefore, BOYLE:
Breathe (as you ascend)
Or
Your
Lung
Explodes
· Breathe as you ascend after scuba diving, since the pressure decreases on
surfacing, so the gas volume in lungs increases.


Unconciousness: differential FISH SHAPED:
Fainted
Illness/ Infantile febrile convulsions
Shock
Head injuries
Stroke (CVE)
Heart problems
Asphxia
Poisons
Epilepsy
Diabetes


Endotracheal tube: troubleshooting DOPEY:
Displaced: esophagus, right mainstem, back of throat, etc
Obstructed: secretions, blood, mucus plug, kink, etc
Pneumothorax
Equipment: malfunctions, O2, ETT, BVM, ventilator, monitor
You: your approach, technique: missing something?


Organophosphates poisoning symptoms MILES:
Miosis
Increased urinary frequency
Lacrimation
Enuresis
Salivation


Chest pain treatment, for nurses "MOVE your
patient!":
Monitor: put patient on cardiac monitor
Oxygen: put patient on O2
Venous: gain large bore venous access
EKG: 12 lead EKG


ICU confusion causes ICU CONFUSION:
ICU psychosis
Cardiac output low [hypotension, post cardiac arrest]
Uncontrolled temperature [hypo/hyperthermia]
Convulsion [post ictal]
Oxygen [hypoxia, hypercarbia]
Nociception [pain]
Full bladder
Uremia
Sugar [hypo/hyperglycemia]
Infection
Opiates
Natremia [hypo/hyper]


Coma: conditions to exclude as cause MIDAS:
Meningitis
Intoxication
Diabetes
Air (respiratory failure)
Subdural/ Subarachnoid hemorrhage


Resuscitation: basic steps ABCDE:
Airway
Breathing
Circulation
Drugs
Environment


Malignant hyperthermia treatment "Some Hot 
D
ude Better Give Iced Fluids Fast!" (Hot
dude = hypothermia):
Stop triggering agents
Hyperventilate/ Hundred percent oxygen
Dantrolene (2.5mg/kg)
Bicarbonate
Glucose and insulin
IV Fluids and cooling blanket
Fluid output monitoring/ Furosemide/ Fast heart
[tachycardia]


Vfib/Vtach drugs used according to ACLS "Every Little
Boy Must Pray":
Epinephrine
Lidocaine
Bretylium
Magsulfate
Procainamide


Coma causes checklist AEIOU TIPS:
Acidosis/ Alcohol
Epilepsy
Infection
Overdosed
Uremia
Trauma to head
Insulin: too little or or too much
Pyschosis episode
Stroke occurred


Shock: types RN CHAMPS:
Respiratory
Neurogenic
Cardiogenic
Hemorrhagic
Anaphylactic
Metabolic
Psychogenic
Septic
· Alternatively: "MR. C.H. SNAP", or "NH CRAMPS"


Shock: signs and symptoms TV SPARC CUBE:
Thirst
Vomiting
Sweating
Pulse weak
Anxious
Respirations shallow/rapid
Cool
Cyanotic
Unconscious
BP low
Eyes blank


Fall: potential causes CLADE SPADE:
Cardiovascular/ Cerebrovascular
Locomotor (skeletal, muscular, neurological)
Ageing (increased body sway, decreased reaction time)
Drugs (esp. antihypertensives, antipsychotics)
Environmental
Sensory deficits (eg. visual problems)
Psychological/ Psychiatric (depression)
Acute illness
Dementia
Epilepsy


Acute LVF management LMNOP:
Lasex (frusemide)
Morphine (diamorphine)
Nitrates
Oxygen (sit patient up)
Pulmonary ventilation (if doing badly)


Subarachnoid hemorrhage (SAH) causes BATS:
Berry aneurysm
Arteriovenous malformation/ Adult polycystic kidney disease
Trauma (eg being struck with baseball bat)
Stroke

Embryology Mnemonics


Embryology Mnemonics


Mitosis: events at 4 stages · Prophase, Metaphase, Anaphase,
Telophase:
Prophase: Chromosomes and spindles are Produced.
Metaphase: chromosomes MetAlign themselves.
Anaphase: [Ana] divorced or separated.
Telophase: Tell-O'Brien his daughter cells are ready.


Woffian duct (mesonephric duct) derivatives. Gardener's
SEED
:
· Female:
Gartner's duct, cyst
· Male:
Seminal vesicles
Epididymis
Ejaculatory duct
Ductus deferens


Potter syndrome: features POTTER:
Pulmonary hypoplasia
Oligohydrominios
Twisted skin (wrinkly skin)
Twisted face (Potter facies)
Extremities defects
Renal agenesis (bilateral)


Fetal alcohol syndrome (FAS): features FAS:
Facial hypoplasia/ Forebrain malformation
Attention defecit disorder/ Altered joints
Short stature/ Septal defects/ Small I.Q


Tetrology of Fallot PROVe:
Pulmonary stenosis
Right ventricular hypertrophy
Overriding aorta
Ventricular septal defect


Neuroectoderm derivatives Neuroectoderm gives rise
to:
Neurons
Neuroglia
Neurohypophysis
piNeurol (pineal) gland


Foregut derivatives "Little Embryo People
DLike Swallowing, Producing Gas":
Lungs
Esophagus
Pancreas
Duodenum (proximal)
Liver
Stomach
Pancreas
Gall bladder


Heart: primitive heart chambers in fetal heart "The
Broken Vein Always Stenoses, But Veins
Are Smooth":
· The order of the compartments is:
<b<t< b>runcus, bulbus
Primitive Ventricle
Primitive Atrium
Sinus venosus
·The connections are:
Bulbotruncal junctionVentriculobulbar foramen
Atrioventricular canal
Sinuatrial junction


Tetrology of Fallot "Problems OSmall
Hearts":
Pulmonary stenosis
Overriding aorta
Ventricular Septal defect
Hypertrophy of right ventricle


Weeks 2, 3, 4 of development: an event for each Week Two:
Bilaminar germ disc.
Week ThreeTrilaminar germ disc.
Week FourFourlimbs appear.


Lung development phases "Every Premature Child
Takes Air":
Embryonic period
Pseudoglandular period
Canalicular peroid
Terminal sac period
Alveolar period


Branchial arch giving rise to aorta "Aor- from 
Four
":
Aorta is from fourth arch.


Placenta-crossing substances "WANT MHot
Dog":
Wastes
Antibodies
Nutrients
Teratogens
Microorganisms
Hormones/ HIV
Drugs


Cranial and spinal neural crest: major derivatives GAMES:
Glial cells (of peripheral ganglia)
Arachnoid (and pia)
Melanocytes
Enteric ganglia
Schwann cells


Tetrology of Fallot "Don't DROP the baby":
Defect (VSD)
Right ventricular hypertrophy
Overriding aorta
Pulmonary stenosis


Mesoderm components MESODERM:
Mesothelium (peritoneal, pleural, pericardial)/ Muscle (striated,
smooth, cardiac)
Embryologic
Spleen/ Soft tissue/ Serous linings/ Sarcoma/ Somite
Osseous tissue/ Outer layer of suprarenal gland (cortex)/ Ovaries
Dura/ Ducts of genitalia
Endothelium
Renal
Microglia/ Mesenchyme/ Male gonad


Tetrology of Fallot "IHOP-International House of
Pancakes":
Interventricular septal defect
Hypotrophy of right ventricle
Overriding aorta
Pulmonary stenosis


Teratogenesis: when it occurs TEratogenesis is most
likely during organogenesis--between the:
Third and
Eighth weeks of gestation.


Vitelline duct: closure time VItelline duct normally
closes around week VI of intrauterine life.

Dermatology Mnemonics


Dermatology Mnemonics


Herpes zoster: medications "AAAA":
Acyclovir (or alternative depending on price: valacyclovir, famciclovir)
Asprin (or other analgesics)
Amitriptyline (low dose TCA to reduce neurlagia)
Antibiotics if needed for secondary infection.


Erythema nodosum: causes DIPS OUT:
Drugs (eg sulfonamides)
Infections (eg strep)
Pregnancy
OCP
Ulcerative colitis
TB


Pruritus: systemic causes ITCH:
Iron deficiency anemia/ Internal malignancy
Thyroid disease/ Type 1 DM
CRF/ Chronic liver disease
HIV infection/ Hereditary hemochromatosis


Malignant melanoma: 3 sites with poor prognosis BANS:
Back of Arm
Neck
Scalp


Albinism: type I vs. II classification "One has 
None
Two Accumulates":
Type I: have no pigment.
Type II: No pigment at birth, but accumulates as person ages.


Generalized skin hyperpigmentation: causes "With
generalized, none of skin is SPARED":
Sunlight
Pregnancy
Addison's disease
Renal failure
Excess iron (haemochromatosis)
Drugs (eg busulphan)


Clubbing: causes CLUBBING:
Cyanotic heart disease
Lung disease (hypoxia, lung cancer, bronchiectasis, cystic fibrosis)
UC/Crohn's disease
Biliary cirrhosis
Birth defect (harmless)
Infective endocarditis
Neoplasm (esp. Hodgkins)
GI malabsorption


Cutaneous inflammation patterns "Pus of
Pig Valve"
· Remove the vowels: PSFPGVLV:
Psoriaform
Spongiotic (eczematous)
Folliculitis
Panniculitis
Granulomatous
Vasculopathic
Lichenoid
Vessiculobullous


Nodules: painful cutaneous nodules causes BENGAL CO.:
Blue rubber bleb nevus
Eccrine spiradenoma
Neurilemmoma/ Neuroma
Glomus tumor
Angiolipoma/ Angioleiomyoma/ Angiosarcoma
Leiomyoma
Cutaneous endometriosis/ Calcinosis cutis
Osteoma cutis


Wound healing: factors delaying DID NOT HEAL:
Drugs
Infection/ Icterus/ Ischemia
Diabetes
Nutrition
Oxygen (hypoxia)
Toxins
Hypothermia/ Hyperthermia
EtOH
Acidosis
Local anesthetics


White patch of skin: differential "Vitiligo PATCH":
Vitiligo
Pityriasis alba/ Post-inflammatory hypopigmentation
Age related hypopigmentation
Tinea versicolor/ Tuberous sclerosis (ashleaf macule)
Congenital birthmark
Hansen's (leprosy)


Psoriasis: pathophysiology PSORIASIS:
Pink Papules/ Plaques/ Pinpoint bleeding (Auspitz
sign)/ Physical injury (Koebner phenomenon)/ Pain
Silver Scale/ Sharp margins
Onycholysis/ Oil spots
Rete Ridges with Regular elongation
Itching
Arthritis/ Abscess (Munro)
Stratum corneum with nuclei, neutrophils
Immunologic
Stratum granulosum absent/ Stratum Spinosum thickening


Raynaud's phenomenon: causes COLD HAND:
Cryoglobulins/ Cryofibrinogens
Obstruction/ Occupational
Lupus erythematosus, other connective tissue disease
Diabetes mellitus/ Drugs
Hematologic problems (polycythemia, leukemia, etc)
Arterial problems (atherosclerosis)
Neurologic problems (vascular tone)
Disease of unknown origin (idiopathic)
Related Posts Plugin for WordPress, Blogger...