Patient Assessment Skills – part 2

I found this excellent article on a blog called EMT Resource

A deeper look at the “S” in SAMPLE

The SAMPLE acronym is usually taught within the first few weeks of EMT school and is a fundamental piece of the history taking section of patient assessments. Unfortunately, many students are only taught that the “S” in SAMPLE stands for “signs and symptoms” and they should use the OPQRST acronym to determine what those signs are symptoms are. The OPQRST acronym is great for assessing cardiac and traumatic related emergencies, but it shouldn’t be used for every type of chief complaint. For instance, OPQRST can be slightly modified to work for a patient experiencing a respiratory emergency; however, it’s generally a better idea to use the PASTE acronym instead. By using PASTE, you can gather more relevant information about the patient’s chief complaint and therefore conduct a better assessment. Below are lists of questions you can ask patients for each type of emergency when doing your SAMPLE history.
Questions to Ask for the “S” in SAMPLE

Respiratory

• OPQRST or PASTE (generally a better alternative)

Cardiac / Trauma

• OPQRST

Altered Mental Status

• Description of the epsiode.
• What was the patient doing when the signs and symptoms first occurred? Was the onset sudden or gradual?
• How long has it been going on?
• Are there any associated symptoms?
• Is there evidence of trauma?
• Any interventions?
• Possibility of a seizure?
• Does the patient have a fever?

Allergic Reaction

• Is there a history of allergies?
• What was the patient exposed to?
• What are the effects?
• Is it progressing? If so, how?
• Any interventions?

Poisoning / Overdose

• What was the substance?
• When did the patient ingest or become exposed?
• How much did the patient ingest or how much were the exposed to?
• Over what time period?
• Any interventions?
• What is the patient’s estimated weight?

Environmental

• What was the source?
• What was the environment?
• How long was the exposure?
• Was there a loss of consciousness?
• Are there any general or local effects?

Obstetric

• Is the patient pregnant?
• How long has the patient been pregnant for?
• Is there any pain or contractions?
• Is there any bleeding or discharge?
• Does the patient feel the need to push?
• When was the patient’s last menstrual period?
• Is this the first pregnancy? If not, were there any complications with the previous pregnancies?

Behaviorial

• How does the patient feel?
• Does the patient have suicidal tendencies?
• Is the patient a threat to themself or others?
• Does the patient have any medical problems?
• Any interventions?