First Responder EMS Curriculum for Training Centers in Eurasia

6. Patient HistorySome patients wear medical identification tags that may be beneficial in identifyingallergies, medications, or past medical history. Look for medical identification tags duringthe physical exam.a. “SAMPLE” HistoryYou can use the “SAMPLE” mnemonic to remember the essential elements of thepatient history. For medical patients the “SAMPLE” history may be completed beforethe physical exam.S – Signs/SymptomsWhy did you call EMS today? Determine why EMS was called for this patient if it isnot immediately obvious, e.g., motor vehicle accident. For most medical patients, thereason for the emergency call is usually because of worrisome physical signs and/orsymptoms. These signs and/or symptoms constitute the patient’s chief complaint. A signis any medical or trauma condition displayed by the patient that is identifiable by theFirst Responder. For example, a patient with respiratory distress may have noisyrespirations that the First Responder can hear. A patient with bleeding that is externalwill have blood visible that the First Responder can see. A patient with a fever may havewarm skin that the First Responder can feel. Symptoms are any condition that the patientdescribes, but that the First Responder would not be able to identify with their ownsenses, such as difficulty breathing, headache, or pain.A – AllergiesAre you allergic to anything? It is important to identify any allergies the patient mighthave so they are not given anything that might cause an allergic reaction. A patient canhave allergies to medications, the environment (dust, mold, animal hair, etc.), or food.M – MedicationsDo you take any prescription or non-prescription medicine? Determine if the patient iscurrently taking any medications, either by prescription from a physician or nonprescriptionmedication purchased over –the counter at a pharmacy or other store. Alsodetermine whether the patient may have been taking any medications that he/sherecently discontinued.P – Pertinent Past HistoryAre you seeing a doctor for anything? Have you ever been in the hospital? Determinewhether the patient has seen a doctor for any medical or surgical problems or if he/shewas admitted to a hospital, either recently or in the past. Also determine if he/she hasexperienced any trauma, either recently or in the past.L – Last Oral Intake: Solid or LiquidWhen was the last time you had anything to eat or drink? Determine the time andquantity of the last oral intake of solids or liquids. If the patient ends up requiringsurgery and must be put under general anesthesia, the anesthesiologist will need toknow whether the stomach is full in order to take any necessary precautions to preventvomiting and aspiration (inhaling) of stomach contents into the lungs.First Responder EMS Curriculum/AIHA, July 2002 85