• •A — Airway (patent? snoring? stridor?)
• •B — Breathing (rate, depth, SpO₂, breath sounds)
• •C — Circulation (HR, BP, cap refill, bleeding)
• •D — Disability (LOC, GCS, glucose, pupils)
• •E — Exposure (skin, temp, head-to-toe)

Baddie rule 👑: if you can't remember what to do first, start at A. Always.

• •S — Signs & symptoms
• •A — Allergies
• •M — Medications
• •P — Past medical history
• •L — Last oral intake
• •E — Events leading up

• •O — Onset
• •P — Provocation / palliation
• •Q — Quality
• •R — Radiation
• •S — Severity (0–10)
• •T — Timing

• •A — Alert
• •V — responds to Voice
• •P — responds to Pain
• •U — Unresponsive

• •S — Situation (who, what, right now)
• •B — Background (why they're here, pertinent hx)
• •A — Assessment (your nurse gut + vitals)
• •R — Recommendation (what you need from them)

Baddie tip 👑: end every SBAR with a clear ask. Never dump, always request.

• •I — Illness severity
• •P — Patient summary
• •A — Action list
• •S — Situation awareness / contingencies
• •S — Synthesis by receiver

• •M — Morphine (if pain uncontrolled by nitro)
• •O — Oxygen (only if SpO₂ < 90%)
• •N — Nitroglycerin
• •A — Aspirin (chew 162–325 mg)

Baddie truth 👑: MONA is a memory hook — Aspirin comes FIRST clinically.

• •H — Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo/Hyperkalemia, Hypothermia
• •T — Tension pneumo, Tamponade, Toxins, Thrombosis (pulm), Thrombosis (coronary)

• •Goal: PCI within 90 minutes
• •Fibrinolytics: within 30 min if no PCI
• •12-lead within 10 min of arrival

• •L — Lasix (loop diuretic)
• •M — Morphine (reduce preload + anxiety)
• •N — Nitrates
• •O — Oxygen
• •P — Position upright

• •Activity — moves all 4 extremities
• •Respiration — deep breath / cough
• •Circulation — BP within 20% baseline
• •Consciousness — fully awake
• •Oxygen — SpO₂ > 92% on room air

PACU baddie 👑: never discharge on vibes. Score them, chart it, hand off with SBAR.

• •1. Jaw thrust + Larson's point pressure
• •2. 100% O₂ + positive pressure
• •3. Deepen anesthesia (propofol 10–20 mg)
• •4. Succinylcholine 0.1–0.5 mg/kg if unbroken
• •5. Call for help — every time

• •Right patient · Right drug · Right dose
• •Right route · Right time · Right documentation
• •Bonus baddies add: Right reason + Right response

• •TACO — volume Overload: HTN, JVD, crackles, ↑BNP
• •TRALI — acute Lung Injury: hypotension, fever, bilateral infiltrates within 6 hr
• •Both: STOP transfusion, keep line open with NS, notify blood bank

Baddie rule 👑: 'TACO fills 'em up, TRALI drowns 'em.'

• •S — Salivation
• •L — Lacrimation
• •U — Urination
• •D — Defecation
• •G — GI cramps
• •E — Emesis
• •Antidote: Atropine + Pralidoxime

• •F — Face drooping
• •A — Arm weakness
• •S — Speech difficulty
• •T — Time to call 911 / activate stroke

• •↑ Systolic BP with widened pulse pressure
• •↓ HR (bradycardia)
• •Irregular respirations

• •M — Methanol
• •U — Uremia
• •D — DKA
• •P — Paraldehyde / Propylene glycol
• •I — Iron / Isoniazid
• •L — Lactic acidosis
• •E — Ethylene glycol
• •S — Salicylates

• •Respiratory = Opposite (pH ↑, CO₂ ↓ or vice versa)
• •Metabolic = Equal (pH and HCO₃ move together)

Baddie flex 👑: read pH first, then CO₂, then HCO₃. Every. Single. Time.