By Molly Lewis
Whether you are a first year in Physical Diagnosis class, a second year in Continuity Clinic, a third year seeing consults, or an attending deciding if a patient needs emergency surgery, taking a complete history is a key aspect of patient care. How can you remember everything you need to ask? Try a mnemonic!
Mnemonics can get pretty outrageous (try inventing one to memorize all the motile bacteria by type of flagella…), and they may be more difficult to remember than the facts themselves! But, they can be life-savers (or grade-savers!), too!
Any patient interview should start with the HPI (history of present illness, which makes up the “7 dimensions”: Chronology, Location, Quantity, Quality, Aggravating and Alleviating factors (what makes the problem Better or Worse), Setting, and Associated Manifestations. These may seem easy enough to remember without a mnemonic, but when you’re with a patient, are a little nervous, and can’t think of what to ask next, a memory trick can come in handy!
So, taking the first letter of each dimension, I put together the following sentence:
“Cute Ladies Quilting Quilts Black and White So Amazingly”
Ridiculous, I know. But after sweating my way through my first OSCE (a graded test in which you interview and examine an actor pretending to be a patient) without a mnemonic, I invented this one and have used it since!
Another option is the classic “OLDCARTS” (not invented by me!), which stands for “O” = Onset, “L” = Location, “D” = Duration, “C” = Characteristics, “A” = Aggravating and/or relieving factors, “R” = Related symptoms, “T” = Treatments tried (and the patient’s response), and “S” = Severity.
Or, specifically for a patient complaining of pain, consider using OPQRST (another classic I cannot take credit for)- Onset, Position, Quality, Radiation, Severity, and Timing.
Do you have your own method of remembering the 7 dimensions? Post it below! Or, check back later to see if anyone has posted a mnemonic that would work for you!