OPQRST
Onset Provocation Quality Region/Radiation/Referral Severity Time
(AO) X4
Alert and Oriented to person, place, time & events
AVPU
Alert & oriented to person, place, day
V responds to verbal stimuli
P responds to painful stimuli
U unresponsive
SAMPLE
Signs & Symptoms Allergies Medications Pertinent past history Last oral intake Events leading up to event
COASTMAP
Consciousness Orientation Activity Speech Thought Memory Affect Perception
COPD
Chronic obstructive pulmonary disease
SBAR
Situation
Background
Assessment
Recommendation
SOAP
Subjective
Objective
Assessment
Plan for treatment
CHARTE
Chief complaint History Assessment Treatment Transport Exceptions
DCAPBTLS
Deformity Contusions Abrasions Puncture/ Penetrating/ Paradoxal chest movement Burns Tenderness Lacerations Swelling
TIC
Tenderness
Instability
Crepitus