Finding out what is wrong with your patient – asking the right questions!

Pre-hospital care is full of acronyms, and here are two more to learn.

The SAMPLE History

Medical history obtained from the patient, family and bystanders

Signs and Symptoms

Signs: what you can see and measure, such as the vital signs.
Symptoms: what the patient describes to you- pain, numbness…etc. You cannot observe these, so you must ask OPQRST

    Onset: “what were you doing when it started?”
    Provocation or Palliation: “does anything make it worse? Anything makes it better?”
    Quality of pain: “can you describe it to me? Is it sharp, dull, constant, intermittent?”
    Region and Radiation: “where exactly does it hurt? Does the pain extend anywhere else?” (Myocardial infarction produces pain that radiates to the arms and jaw)
    Severity: “on a scale of 1 to 10, how much does it hurt?”
    Time: “how long has this been going on? How has this progressed over time?”

Allergies: “Do you have any allergies?” This includes medication, food, or other environmental factors. Check for medical alert tags.
Medications: “Are you on any medications? Have you taken medications recently?” This includes prescriptions, over-the-counter, birth control pills, illicit drugs (be tactful, indicate that you are not an EMT, not a police officer, and you need the information for treatment purposes), or herbal medicine. Look for medical tags.
Pertinent past history: “Have you ever had any illnesses? Operations? Have you ever been admitted to a hospital?” Find out medical problems and past surgical procedures.
Last meal or drink?: “When did you last eat or drink something? What was it?” A diabetic patient who hasn’t consumed anything for 8 hours may be hypoglycemic.
Events leading up to the injury or illness: “What happened? How did this happen?” The events leading up to the injury provide clues for the underlying cause.