When it comes to EMS (Emergency Medical Services), acronyms play a vital role. They help first responders, paramedics, and healthcare providers communicate quickly and clearly during emergencies. One of the most important tools in EMS is the CHART acronym, a documentation format used to record patient care.
But here’s the thing: EMS professionals don’t only use CHART. They also rely on many other acronyms to guide decision-making, communication, and reporting. This article explores 30 alternatives to the CHART acronym in EMS, when each one is most appropriate, and how subtle differences in tone and context can affect usage.
What Does CHART Stand For in EMS?
CHART = Chief Complaint, History, Assessment, Rx (Treatment), Transport.
It’s a standardized way for EMS providers to write patient care reports. It ensures no critical information is missed while keeping documentation organized.
Nuances:
- Professional tone – used in official medical reporting.
- Reserved style – concise and factual, not emotional.
- Cultural context – widely recognized across EMS in the U.S. and beyond.
30 Alternatives to the CHART Acronym in EMS
Here’s a list of creative and practical alternatives EMS providers and trainers may encounter, each with an explanation, example, and best-use case:
1. SOAP
Meaning: Subjective, Objective, Assessment, Plan
Example: The patient reported chest pain (S). Vital signs confirmed tachycardia (O). Possible angina (A). Administered aspirin, transported to ED (P).
When to Use: Best in both EMS and general healthcare documentation.
2. SAMPLE
Meaning: Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events leading up
Example: Collected SAMPLE before treatment—patient allergic to penicillin.
When to Use: Ideal during patient assessment for quick history.
3. OPQRST
Meaning: Onset, Provocation, Quality, Region, Severity, Time
Example: Chest pain started 20 minutes ago, sharp, radiating to arm.
When to Use: Useful for assessing pain or specific symptoms.
4. MIST
Meaning: Mechanism of injury, Injuries found, Signs, Treatment
Example: Motor vehicle crash, head laceration, BP 90/60, IV fluids started.
When to Use: Best for handoff during trauma cases.
5. DCAP-BTLS
Meaning: Deformities, Contusions, Abrasions, Punctures, Burns, Tenderness, Lacerations, Swelling
Example: Head-to-toe exam showed abrasions on chest, swelling on leg.
When to Use: Physical trauma assessment.
6. AEIOU-TIPS
Meaning: Alcohol, Epilepsy, Insulin, Overdose, Uremia, Trauma, Infection, Psych, Stroke
Example: Altered mental status → ruled out AEIOU-TIPS causes.
When to Use: Differential diagnosis for unconscious or altered patients.
7. AVPU
Meaning: Alert, Verbal, Pain, Unresponsive
Example: Patient responsive to pain only (P).
When to Use: Quick neurological check.
8. GCS (Glasgow Coma Scale)
Meaning: Eye, Verbal, Motor response scoring
Example: Patient GCS 12 on arrival.
When to Use: Neurological assessment, esp. head trauma.
9. ABCs
Meaning: Airway, Breathing, Circulation
Example: Checked ABCs before transport—airway clear, breathing labored.
When to Use: First priority in any emergency situation.
10. CAB
Meaning: Circulation, Airway, Breathing
Example: Cardiac arrest case—started with CAB approach (compressions first).
When to Use: Updated CPR guidelines, cardiac emergencies.
11. TICLS
Meaning: Tone, Interactiveness, Consolability, Look/Gaze, Speech/Cry
Example: Infant scored normal on TICLS assessment.
When to Use: Pediatric patient assessment.
12. ISBAR
Meaning: Introduction, Situation, Background, Assessment, Recommendation
Example: ISBAR used to hand off patient to ER staff.
When to Use: Professional communication between providers.
13. MOSAIC
Meaning: Mechanism, Observations, Signs, Assessment, Interventions, Communication
Example: Completed MOSAIC during trauma evaluation.
When to Use: Holistic EMS documentation.
14. RACE
Meaning: Rescue, Alarm, Confine, Extinguish
Example: RACE followed during hospital fire drill.
When to Use: Fire safety in medical facilities.
15. PASS
Meaning: Pull, Aim, Squeeze, Sweep
Example: Nurse remembered PASS while using extinguisher.
When to Use: Fire extinguisher operation.
16. AEIOU
Meaning: Alcohol, Epilepsy, Insulin, Overdose, Uremia
Example: Considered AEIOU causes for altered patient.
When to Use: Quick differential diagnosis.
17. H’s & T’s
Meaning: Hypoxia, Hypovolemia, Hydrogen ion, Hypo/Hyperkalemia, Hypothermia, Toxins, Tamponade, Tension pneumothorax, Thrombosis
Example: Reviewed H’s & T’s during code blue.
When to Use: ACLS cardiac arrest protocols.
18. DRABCDE
Meaning: Danger, Response, Airway, Breathing, Circulation, Disability, Exposure
Example: DRABCDE followed on trauma scene.
When to Use: Scene safety + patient assessment.
19. CABDE
Meaning: Circulation, Airway, Breathing, Disability, Exposure
Example: CABDE emphasized in trauma response.
When to Use: Alternative trauma sequence.
20. AMPLE
Meaning: Allergies, Medications, Past history, Last oral intake, Events leading up
Example: Gathered AMPLE history pre-transport.
When to Use: Expanded patient history.
21. LEMON
Meaning: Look, Evaluate, Mallampati, Obstruction, Neck mobility
Example: LEMON checklist suggested difficult airway.
When to Use: Airway assessment.
22. MONA
Meaning: Morphine, Oxygen, Nitroglycerin, Aspirin
Example: MONA administered for suspected MI.
When to Use: Chest pain/cardiac emergencies.
23. PERRLA
Meaning: Pupils Equal, Round, Reactive to Light and Accommodation
Example: PERRLA normal on neuro exam.
When to Use: Neurological/eye assessment.
24. DCAP-IC
Meaning: Deformities, Contusions, Abrasions, Penetrations, Instability, Crepitus
Example: DCAP-IC checked during head-to-toe exam.
When to Use: Trauma assessment alternative.
25. OPQRST-AAA
Meaning: Onset, Provocation, Quality, Region, Severity, Time – Aggravating, Alleviating, Associated factors
Example: Used OPQRST-AAA for abdominal pain history.
When to Use: Expanded symptom history.
26. FAST
Meaning: Face, Arm, Speech, Time
Example: FAST test indicated possible stroke.
When to Use: Stroke recognition.
27. SAMPLE-R
Meaning: SAMPLE + Risk factors
Example: Added smoking history with SAMPLE-R.
When to Use: Risk factor documentation.
28. SLUDGE
Meaning: Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis
Example: SLUDGE symptoms pointed to organophosphate poisoning.
When to Use: Toxin/poisoning cases.
29. DERM
Meaning: Depth, Edema, Redness, Moisture
Example: DERM noted in burn patient.
When to Use: Burn assessment.
30. RPM
Meaning: Respirations, Perfusion, Mental status
Example: RPM used in mass casualty triage.
When to Use: Quick triage in disasters.
Choosing the Right Acronym in EMS
Not all acronyms work in every context. Here’s a quick guide:
- For documentation → CHART, SOAP, ISBAR
- For assessment → SAMPLE, OPQRST, DCAP-BTLS
- For critical action → ABC, CAB, PASS, RACE
- For handoff/communication → MIST, ISBAR, MOSAIC
Tone and context matter: SOAP feels more clinical, while SAMPLE is quick and conversational. Trauma cases often rely on DCAP-BTLS and MIST, while AEIOU-TIPS shows deeper diagnostic reasoning.
Conclusion
The CHART acronym in EMS is reliable and widely used, but it’s not the only tool. Depending on whether you’re documenting, assessing, or communicating, alternatives like SOAP, SAMPLE, OPQRST, MIST, and DCAP-BTLS may be more appropriate.
By understanding these subtle distinctions, EMS providers can improve clarity, save time, and ensure better patient care. The key is knowing your audience—whether it’s a fellow paramedic, ER staff, or a training scenario—and choosing the acronym that resonates best.
