What does SAMPLE acronym mean?
SAMPLE stands for Signs & symptoms, Allergies, Medications, Past medical history, and Events leading up to the incident.
When do we use SAMPLE Questions?
There are slight variations of the sample history between lay public, nurses and physicians, however the overall theme is the same: medical assessment of patients. SAMPLE questions help gather medical history during the secondary assessment to distinguish if the patient has a life threatening condition and what is causing their condition.
What are First Aid Sample Questions?
First Aid SAMPLE History Questions
Signs and Symptoms
Signs are something we can see is wrong with our patient. Signs include bleeding, pale skin, swelling, bruising, rash, sweat, etc. Signs answer the question "what do you see?"
If you see the patient is pale, sweaty and has difficulty breathing, they may be experiencing a life threatening condition called shock.
Symptoms are subjective feelings the patient is experiencing. Symptoms include pain, headache, dizziness, hot, nausea, etc. Symptoms answer the question "How do you feel?"
It is a good idea to ask further questions about how a patient feels. Reference if the patients symptoms are appropriate for their age, health, and recent activities. If the patient has not experienced this feeling before, it is likely more serious than if it is something they have been experiencing for a long time.
Signs and symptoms are not mutually exclusive and may overlap. For example, the patient will be able to feel their bloody nose and you will be able to see it.
Allergies
It is best to be direct and ask the patient "Are you allergic to anything?" If the patient had a previous allergic reaction they will tell you. Other considerations include:
Is the patient allergic to any medications?
Is there an environmental allergen that is affecting the patient?
Has the patient been exposed to anything they may be allergic to?
It is common for people to have allergies to pollen, peanuts, milk, eggs, fur, insect stings, latex, mold, cockroaches, shellfish, soy, gluten, dust mites, etc. If the patient tells you they are allergic to something that you are not familiar with, such as sulfa drugs (antibiotics containing sulfonamides), simply ask the patient what it is and if they may have been exposed to it recently.
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Medications
Find out if the person is taking any prescribed medications and if they have been taking them as prescribed. Many patients are non-compliant with their prescribed medications. Useful questions to ask include:
Do you take any medications?
Have you been taking your medications as prescribed by the doctor?
People carry medications for problems they have. If the patient takes insulin regularly, you know that they are diabetic. Gather more information to figure out if their condition may be resolved by taking sugar or insulin (NEVER administer insulin if you are not trained in administering insulin). If the person uses medication you are not familiar with, ask them what the medication is used to treat. For example, after further investigation you may find out that the patient takes Ventolin (via asthmatic inhaler) to treat their asthma. If you suspect the patient might pass out, write down the names of the medications the patient takes before you forget!
If the person is unconscious and breathing, look for medic alerts around their body or medications in their bags, pocket or wallet. Ask any bystanders if they know that the patient has any medical conditions.
If you suspect the person is experiencing an overdose, administer naloxone (Narcan), if available. Ask the patient or bystanders questions to figure out what drugs they took, how much they took, when they took it, if they took more than they usually do, and if they mixed the drugs with other drugs (including alcohol).
Past Medical History
Get the patients medical history. Ask the patient "Do you have any medical conditions?". Keep the conversation relevant. The athletes foot they experienced as a teenager is not relevant right now.
Another good question to ask is "Have you experienced this feeling/pain before?" If the patient has experienced these symptoms before they might be able to tell you what caused the previous episode.
Many people will deny having past medical history yet they will tell you that they take medication for a condition. So it's a good idea to ask both of these questions in tandem.
If the patient experienced this pain before, ask them how it compares (better/worse) to the last time they felt this pain. Is it a new pain or has an existing injury been aggravated? Did they have recent surgery? Does the current chest pain feel similar to the time they tore their muscle or the last time they experienced a heart attack? The answer to that question will have different implications.
It is good to note that patients may have more than one injury or medical emergency. Don't be distracted by the most obvious injury! For example, a motorcyclist may have just crashed their vehicle due to their low sugar levels affecting their motor ability.
Last Oral Intake
Ask them "When was the last time you had anything to eat/drink?" You may find out they haven't ate recently or that they ate something they are allergic to. Maybe they are dehydrated from not having enough fluids. Maybe they are feeling ill from food poisoning.
If the person is experiencing something that they may require surgery for, such as severe internal bleeding, it is important to note the last time they ate or drank, as it may complicate surgery.
Low sugar levels affects everyone, not just diabetics. People with low sugar levels will likely experience hunger, shaking, dizziness, confusion/irritability, anxiety, sweating and fast heart rate. If a patient experiencing low sugar levels has been successfully treated, it is important to have them eat a more complete meal with complex carbohydrates, fats, and proteins. Simple sugars like glucose are quickly used up in the body. Therefore, it is recommended to have someone watch over the patient until they finish their meal, just in case they relapse.
Events Leading Up To The Incident
What are the events leading up to the injury or illness? Are there any extenuating circumstances? Ask them "What happened?"
If the patient is experiencing trauma, such as a bleed, your focus should be on controlling the bleeding first. If the patient is not experiencing trauma then they may have a medical emergency. You will need to ask more questions need to get an idea of what may be causing their symptoms. Were they running or sitting down when they felt chest pain? It is more worrying if the patient has a high heart rate while at rest versus after completing a run.
If the patient can't tell you what happened, ask bystanders. If no one saw anything, look at the scene for clues. Is there an obvious mechanism of injury? Maybe they fell off the ladder they are laying beside. Perhaps they experienced a medical emergency. Are they wearing any medical alert bracelets/necklace/tattoo? Did anyone hear anything?
Natural progression of SAMPLE questions
How to ask SAMPLE questions. The SAMPLE mnemonic is not a script and does not have to be asked in order. You can ask SAMPLE questions naturally in any order you want while you are treating treat your patient. A possible line of questioning may go as follows:
What happened? (Events leading up to the incident)
How do you feel? (Signs and Symptoms)
Has this happened before? (Past)
Do you take any medications? (Medication)
Do you have any allergies? (Allergies)
When was the last time you ate? (Last oral intake)
Multiple questions can be asked in each category if necessary. For example, if the patient experienced this pain before, a natural follow up question is "how does the pain compare to the last time?"
Tips
SAMPLE questions can be combined with vital signs and OPQRST (to evaluate pain) to get a more complete picture.
Ask questions early on so that way if they go unconscious you will still have something to report to paramedics.
Try not to ask leading questions. An example of a leading question is "That hurts a lot doesn't it?" Instead ask "How do you feel?"
Act confident even when you are scared. If the patient feels like you have some control of the situation it will help calm them down. If you are freaking out, they will mirror you.
The Sample questions are used to guide our basic medical assessment of our patient.
Get confident – get trained!
Knowing what to do BEFORE it happens is essential to providing quality care and making a difference in some ones life. Our first aid courses will give you the knowledge and the confidence you need to deal with many first aid incidents.
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