Excellent CHEATED

CHEATED is Chief, History, Exam, Assessment, Treatment, Evaluation, Disposition. Two different E's are the whole point. Exam is what you found on the body. Evaluation is what changed after treatment. Agencies that use CHEATED are trying to stop "treated and transported" with no recheck.

C and H

C is the complaint in patient words. H is the story: onset, historians, SAMPLE, negatives. Same discipline as CHART's C and H.

E — Exam (the first E)

Physical findings before or during your first interventions: airway, work of breathing, lung sounds, skin, abdomen, neuro, obvious injuries. Include the first vital set here or immediately adjacent. Exam is not the impression.

A — Assessment

Working impression. One line is enough if Exam was complete: suspected asthma exacerbation, suspected ACS, postictal after generalized seizure.

T — Treatment

Dose, route, time. Albuterol 2.5 mg nebulized at 21:24. Oxygen 2 L NC. Do not hide response inside T — that is the second E.

E — Evaluation (the second E)

This is where excellent CHEATED pulls ahead. Recheck vitals. Quote the new symptom language ("easier to breathe"). Pain 8→5. SpO2 86%→92%. Wheeze quieter. GCS 13→15. If nothing changed, say so with numbers, not "unchanged and fine."

D — Disposition

Destination, position, who rode, report given. Or a full refusal pack. Or IFT receiving facility. Necessity belongs here: required oxygen/nebs, could not go by POV.

Walkthrough — fictional COPD

C: "I can't get the air out. This is my COPD."

H: Three days thicker yellow sputum; tonight worse at 20:40; home oxygen 2 L not helping; denied chest pain, no fever.

E: Tripod, pursed-lip, diffuse wheeze, no crackles, no JVD. 21:22 BP 146/88 HR 108 RR 28 SpO2 86% RA.

A: COPD exacerbation.

T: Nebulized albuterol 2.5 mg at 21:24; oxygen 2 L NC (home baseline).

E: 21:36 SpO2 92% 2 L, RR 22, wheeze quieter, speech improved.

D: Upright ALS to ED; spouse followed; bedside report.

CHEATED failure modes

• One E that mixes exam and "patient improved."
• Evaluation with no second vital set.
• Disposition that is only "hospital."
• Assessment copied from Exam.
• Using C: H: E: A: T: E: D: headings — that is correct CHEATED structure; just fill every heading.

When you score a CHEATED drill, the rubric looks for those letter headings. Write them. Then make Evaluation earn its name.