In the world of emergency medical services, clarity and quick thinking can save lives. One tool EMTs (Emergency Medical Technicians) rely on during patient assessment is the PASTE acronym.
It’s a focused mnemonic designed to assess respiratory distress, often used alongside or in place of SAMPLE or OPQRST when the issue is breathing-related.
But what happens when you want to expand your descriptive vocabulary beyond PASTE while maintaining precision, emotional sensitivity, or fitting specific clinical or educational contexts?
That’s where this guide comes in.
We’ll start by explaining what PASTE stands for in the EMT field, then move on to 30 carefully selected alternatives—synonym-like acronyms or phrases—each with a specific nuance, usage tip, and example.
🚑 What Does PASTE Stand For in EMT?
PASTE is used to quickly evaluate patients experiencing shortness of breath or respiratory symptoms:
- P – Provoking Factors (What makes it better or worse?)
- A – Associated Chest Pain
- S – Sputum (Color, presence, quantity)
- T – Talking/Tiredness (Can they talk in full sentences? Fatigue level)
- E – Exercise Tolerance (Has it changed recently?)
This tool helps EMTs focus on what matters most in the field: breathing difficulty causes and severity.
🔄 Why Look for Alternatives?
Sometimes you need alternatives to PASTE when:
- Teaching EMT students variations of assessment
- Creating documentation with richer language
- Adjusting tone for patient communication
- Incorporating cultural or emotional sensitivity
Below are 30 thoughtful alternatives—some acronyms, others conceptual tools—that can enrich how you understand and assess respiratory issues or support patient care.
🩺 30 Alternatives to PASTE Acronym EMT (with Examples)
1. BREAD – Breathing Rate, Effort, Accessory Muscles, Dyspnea
Used to assess visual breathing cues.
“Check for BREAD signs before auscultation.”
2. DICE – Dyspnea, Inspiration/Expiration Ratio, Cyanosis, Effort
Highlights physical signs of respiratory distress.
“The patient showed DICE indicators, especially cyanosis.”
3. RICE – Respirations, Inspiration Depth, Cyanosis, Exertion
Simple breakdown for rapid bedside checks.
“RICE findings were positive—transport urgently.”
4. SOAP – Subjective, Objective, Assessment, Plan
Not respiratory-specific but essential for structured reporting.
“Use SOAP notes for documentation.”
5. OPQRST – Onset, Provocation, Quality, Radiation, Severity, Time
Broader than PASTE but helpful in symptom exploration.
“After OPQRST, we narrowed it down to asthma.”
6. SAMPLE – Signs/Symptoms, Allergies, Meds, Past history, Last intake, Events
Useful in combination with PASTE.
“SAMPLE and PASTE together gave the full picture.”
7. TICLS – Tone, Interactiveness, Consolability, Look/Gaze, Speech/Cry
Pediatric-focused tool.
“Infant passed TICLS, no distress noted.”
8. ABCDE – Airway, Breathing, Circulation, Disability, Exposure
Primary trauma assessment tool.
“Always do ABCDE in every trauma call.”
9. DR-GERMS – Dyspnea, Rales, Grunting, Effort, Retractions, Mood, Sounds
Pediatric respiratory signs.
“Use DR-GERMS to rule out bronchiolitis.”
10. CHART – Chief Complaint, History, Assessment, Rx Given, Transport
Good for report writing.
“CHART it clearly after intervention.”
11. WOB – Work of Breathing
Focuses on effort and accessory muscle use.
“His WOB is severe—non-rebreather needed.”
12. Dyspnea Scale (1-10)
Use to quantify breathlessness.
“She rates her dyspnea at 8.”
13. AIRS – Airway, Inspiration, Respiratory Rate, Sounds
Basic airway monitoring.
“Check AIRS before escalation.”
14. PEARL – Pupils Equal And Reactive to Light
Used with altered LOC and oxygenation check.
“PEARL positive—oxygenation seems adequate.”
15. PERRLA – Pupils Equal, Round, Reactive to Light & Accommodation
Used when O2 saturation is low or CO2 high.
“PERRLA intact despite low SpO2.”
16. CUPS – Critical, Unstable, Potentially Unstable, Stable
Patient condition classification.
“The patient is ‘U’ on CUPS scale.”
17. AVPU – Alert, Verbal, Pain, Unresponsive
Used to assess consciousness, indirectly related to O2 levels.
“Patient is V on AVPU—possible hypoxia.”
18. GASP – Gag Reflex, Airway, SpO2, Pulse
Great for trauma or overdose situations.
“GASP was poor—intubation indicated.”
19. RATS – Respirations, Accessory muscles, Tracheal tug, Skin color
Quick pediatric check.
“RATS signs seen—likely respiratory fatigue.”
20. LUNG – Listen, Use O2, Note patterns, Gauge severity
For beginner-friendly teaching.
“LUNG made it easy to teach new medics.”
21. RESP – Rate, Effort, Sounds, Position
Direct and clear respiratory tool.
“RESP check revealed wheezing and tripod posture.”
22. SPIRAL – Symptoms, Past illness, Inhaler use, Rate, Auscultation, Level of activity
Expanded PASTE-style form.
“SPIRAL showed asthma history.”
23. RAPID – Respiratory rate, Accessory use, Position, Inspiration sound, Dyspnea score
Scene-level checklist.
“Do a RAPID evaluation before transport.”
24. RALES – Respiratory distress, Adventitious sounds, Level of consciousness, Exertion, Sputum
For heart failure or pulmonary edema patients.
“RALES helped confirm CHF.”
25. COBRA – Cyanosis, Oxygen sat, Breathing rate, Retractions, Accessory use
Used in pediatric EMS settings.
“COBRA signs detected in the child.”
26. HEART – Hypoxia, Effort, Accessory use, Respiratory rate, Tachypnea
Cardio-pulmonary patients.
“HEART mnemonic points to pulmonary embolism.”
27. AIRWAY – Assess, Inspect, Reposition, Watch breathing, Apply O2, Yell for ALS
Quick field mnemonic.
“We followed AIRWAY on the trauma call.”
28. SPOT – SpO2, Pulse, Observation, Talking ability
Use for rapid triage.
“SPOT showed drop in saturation during exertion.”
29. CLEAR – Chest pain, Level of fatigue, Exertion limits, Air hunger, Respiratory rate
Combination of subjective and objective data.
“CLEAR ruled in exertion-induced dyspnea.”
30. FACE – Fatigue, Accessory muscles, Cyanosis, Effort
Use in elderly or post-op patients.
“FACE signs showed respiratory decompensation.”
🧭 How to Choose the Right Alternative
Depending on your goal—clinical care, education, documentation, or patient communication—choose your acronym wisely:
- For pediatric patients: Use DR-GERMS, TICLS, or COBRA.
- For trauma patients: Start with ABCDE or AVPU.
- For structured notes or reports: CHART or SOAP are ideal.
- When breathlessness is chief complaint: Use PASTE, RESP, or SPIRAL.
- For fast visual assessment: Try RATS, FACE, or GASP.
Also consider emotional context. FACE or CLEAR may sound less clinical to a patient than DICE or RALES, and could foster more empathetic conversation.
✅ Conclusion
The PASTE acronym is a powerhouse for respiratory assessment, but having multiple tools in your EMT toolkit ensures you’re always ready—whether for teaching, documentation, or real-world response. By mastering these 30 alternatives, you become not just a responder, but a communicator, educator, and advocate for better patient care.
Breathe deep. Stay focused. Use the right acronym.
