The DOTS mnemonic is a handy tool used to remember the 4 things to look for when conducting a physical assessment.

What do the letters of the DOTS Mnemonic mean?

Deformities –

The “D” of the DOTS menmonic describes abnormal shapes. We all know what shape an arm should be and if it looks more like spaghetti or has an extra bend, that’s a deformity! 

Deformity is usually the result of a dislocation or fracture. Sometimes to find or confirm a deformity it’s best to compare the anatomy on the opposite side of the body. For example, if you’re not sure whether the left ankle is deformed, look at the right angle and compare the two. 

Open Wounds –

The “O” of the DOTS mnemonic is for Open wounds and it refers to lacerations or cuts. These can lead to infection or dangerous bleeding. Sometimes they’re difficult to find especially in an unresponsive casualty. If you’re searching for open wounds, PPE, like gloves, is critically important.

Tenderness –

Sometimes casualties won’t report pain until you press on an area. This type of pain is known as tenderness. Tenderness can occur before other visible signs such as distension or bruising and can indicate serious underlying injuries. If the casualty is unresponsive, you can often still check for tenderness by watching their face for reactions.

Swelling –

Finally, the “S’ of the DOTS mnemonic stands for Swelling. Swelling is often present with soft tissue injuries as well as fractures. It is often a later indication of injury though so you may not find it during your initial assessment!