# Memory Aids

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<summary>The four D's to end your management plans</summary>

* Debrief
* Documentation
* Disposition
* Disclosure

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<summary>The four P's for a good VIVA structure</summary>

These are to structure your responses around so that you don't forget to discuss some element of the stem.

* Patient factors/concerns
* Pathology factors
* Procedural factors
* People required

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<summary><strong>"6 Ps" of Day Surgery Discharge:</strong></summary>

* **Pain** well controlled
* **PONV** minimal or managed
* **Pooping** (passed urine ± tolerating oral intake)
* **Physiologically stable**
* **Plan** for follow-up
* **Person** responsible at home

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<summary>A different DRS ABCD</summary>

* Diagnosis - Most likely/fatal cause
* Removal of Stimulus/offense
* Send for help
* Standard ABCD

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<summary>Rapid differential for ventilatory deterioration (DOPE)</summary>

Use when you see rising airway pressures, desaturation, inadequate ventilation, Sudden EtCO2 changes

#### DOPE

**D** - Displacement&#x20;

**O** - Obstruction

**P** - Pneumothorax

**E** - Equipment failure

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<summary>Approach to Precipitant Induced Collapse (SAFER)</summary>

S - Stop the trigger (volatile, antibiotic, chlorhex, infusion, transfusion)

A - Airway and breathing (100% O2, manual ventilation, deepen anaesthesia/paralysis)

F - First-line therapy (Dantroline, intralipid, adrenalin)

E - Escallate (activate emergency protocols, MH cart, Crash cart)

R - Retrieve (Early planning for and mobilisation to definitive care)

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<summary>Pre-intubation SPEEDBOMB</summary>

n:

* **S** - Suction (ensure suction is ready and working)
* **P** - Positioning (optimal patient positioning)
* **E** - Equipment (laryngoscope, tubes, etc.)
* **E** - End-tidal CO2 (ETCO2 monitoring ready)
* **D** - Drugs (induction and paralytic agents prepared)
* **B** - Back-up (backup airway plan/equipment)
* **O** - Oxygen (pre-oxygenation and oxygen delivery)
* **M** - Monitoring (vital signs monitoring in place)
* **B** - Briefing (team briefing on roles and plan)

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<summary>Post Intubation Care - SPEEDBOMB</summary>

* **S -** Secure the Tube – Tape, holder, or device
* **P -** Prevent Aspiration – Cuff pressure, gastric tube
* **E -** End-tidal waveform capnography
* **E -** Elevate Head – HOB 30–45°
* **D -** Depth Check – Confirm ETT position
* **B -** Blood Gas – Assess oxygenation/ventilation
* **O -** Oxygenation – Lung-protective settings (low tidal volume, appropriate PEEP)
* **M -** Meds – Sedation/analgesia, bronchodilators (nebs/MDI)
* **B -** BVM Ready – Backup ventilation available

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<summary>Post Intubation Hypotension AH SHITE mneumonic</summary>

Thanks to [rebelem](https://rebelem.com/post-intubation-hypotension-the-ah-shite-mnemonic/) for this one (and a massive amount of other things too!)

**A -** Anaphylaxis/Acidosis

**H -** Heart (tamponade/pulmonary Hypertension)

**S -** Stacked Breaths

**H -** Hypovolaemia

**I -** Induction agent overdose

**T -** Tension Pneumothorax

**E -** Electrolytes

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<summary>Debrief team with IMSAFE</summary>

* I – Immediate safety check (are we all okay?)
* M – Medical summary of the case
* S – Share experiences and emotional reactions
* A – Analyse what went well and areas for improvement
* F – Focused discussion on lessons learnt
* E – Engage with follow-up: documentation, duty of candour, counselling

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<summary>CIMPLE approach to Regional Anaesthetic</summary>

* **C -** Consent
* **I -** IV access
* **M -** Monitoring
* **P -** Position
* **L -** Local Anaesthetic Choice
* **E -** Evaluation of block success

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<summary>4Ts of a PPH</summary>

* Tissue
* Tone
* Trauma
* Thrombin

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<summary>AMPLE History</summary>

* **A -** Allergies
* **M -** Medication
* **P -** Past medical/surgical History
* **L -** Last meal
* **E -** Events related to pathology

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<summary>Four A's for an Amergency Anaesthetic</summary>

* **A -** Airway difficulty

- **A -** Aspiration risk (3 time higher)
- **A -** Awareness
- **A -** Allergy

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<summary>SAVE a patient from an infection/sepsis</summary>

* **S -** Source control
* **A -** Antibiotics
* **V -** Volume and Vasopressors
* **E -** Evaluation

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