Clinical Mnemonics · Emergency & Trauma
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A six-part history-taking checklist gathering signs/symptoms, allergies, medications, past medical history, last oral intake, and events leading up to explain why a patient is sick now.
The college version
A six-part history-taking checklist gathering signs/symptoms, allergies, medications, past medical history, last oral intake, and events leading up to explain why a patient is sick now.
S — Signs / Symptoms
What is wrong, seen vs. felt
Gather the chief complaint and the story of the current illness. Signs are objective (fever, bleeding, wheezing); symptoms are subjective (pain, nausea). Documenting both allows tracking and accurate handoff.
Physiology. Objective signs anchor the assessment and are reproducible; symptoms localize the affected body system.
A — Allergies
What the patient reacts to
Ask specifically about drug allergies (penicillin, sulfa, contrast, latex, opioids) and the type of reaction. Distinguish a true allergy (anaphylaxis, hives, swelling) from an intolerance (nausea). Verify before every administration, including contrast and blood products.
Physiology. True allergic reactions are immune-mediated and can be life-threatening; intolerances are dose-related side effects.
Safety. Verify allergies before every medication administration; clarify unlabeled allergies before giving the drug.
M — Medications
What the patient takes
Obtain a complete list including prescriptions, over-the-counter, herbals/supplements, and PRNs, with doses and last times taken. Note recent changes, missed doses, and non-adherence. Many presentations are caused by medications (side effects, toxicity, withdrawal).
Physiology. Drugs modify physiology: beta-blockers mask tachycardia, anticoagulants change bleeding risk, missed antihypertensives cause rebound hypertension.
Safety. Include OTC and herbal products (aspirin, NSAIDs, ginkgo, garlic) that increase bleeding risk.
P — Past medical history
Previous illness and surgery
Ask about chronic conditions (diabetes, hypertension, heart disease, asthma, seizures, cancer), prior surgeries, hospitalizations, and relevant obstetric history. This explains current risk (e.g., a diabetic with chest pain may have a silent MI).
Physiology. Chronic disease changes baseline physiology and risk; knowing the past explains the present and predicts the future.
L — Last oral intake
Last meal or drink
Record the time, amount, and content of the last meal/fluid. This informs aspiration risk before sedation/anesthesia, helps interpret blood glucose in diabetics, and flags prolonged fasting (dehydration, hypoglycemia).
Physiology. A full stomach raises regurgitation/aspiration risk during sedation; prolonged fasting contributes to hypoglycemia and dehydration.
Safety. Fasting status is a required check before any procedure requiring sedation.
E — Events leading up
What happened immediately before onset
Ask what the patient was doing immediately before onset — activity, trauma, exposure, meals, medications, emotional stress. This context is often the single most informative piece and frequently holds the diagnosis.
Physiology. Most acute presentations have an identifiable trigger or mechanism; identifying it explains the event and guides treatment and prevention.
Memory aids
- S = Signs / Symptoms
- A = Allergies
- M = Medications
- P = Past medical history
- L = Last oral intake
- E = Events leading up
Quick review
- S = Signs / Symptoms — What is wrong, seen vs. felt
- A = Allergies — What the patient reacts to
- M = Medications — What the patient takes
- P = Past medical history — Previous illness and surgery
- L = Last oral intake — Last meal or drink
- E = Events leading up — What happened immediately before onset
Eli explains
The same idea, in plain words
Explain it like I’m 10
A six-box 'all about me' form you fill in about any patient, so you know the important background — and never miss something dangerous like an allergy — before you act.
S — Signs / Symptoms. Signs are things others can see or measure (a fever, a rash, fast breathing); symptoms are things only the patient feels (pain, nausea, dizziness). Together they answer 'what's wrong?'
A — Allergies. Allergies ask if the body has ever overreacted to a medicine, food, or other substance — like a car alarm that goes off too easily. We ask because we must never give a medicine that sets off that alarm.
M — Medications. Medications ask what pills, shots, or inhalers the patient takes — like reading the 'what's under the hood' list of a car. It explains symptoms and changes what is safe to give.
P — Past medical history. Past medical history asks what has happened to the body before — big sicknesses, surgeries, hospital stays — like reading the service history of a used car. Past problems often explain today's.
L — Last oral intake. Last oral intake asks when the patient last ate or drank. An empty stomach is safer if surgery is needed, and for diabetics, skipped meals can cause low blood sugar.
E — Events leading up. Events leading up asks what was happening right before this started — the 'story of the moment.' They were stung by a bee, fell off a ladder, or took medicine and felt faint.
Study tools & related lessonsKey vocabulary · Related
Key vocabulary
- S
- Signs / Symptoms
- A
- Allergies
- M
- Medications
- P
- Past medical history
- L
- Last oral intake
- E
- Events leading up
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