SAMPLE stands for Signs & symptoms, Allergies, Medication, Previous relevant medical history, Last oral intake, Event history. And this acronym is one of the most important things in assessing patients quickly. This helps us to direct our examination properly.
SIGNS & SYMPTOMS
After taking information from bystanders or witnesses about signs and symptoms, we need to know. We have to take them down in a chart. It helps us know the patient’s current situation and what kind of treatment they are going through right now.
One important thing regarding signs and symptoms is that we have to keep our eyes open while talking with bystanders or witnesses and take them down immediately because information may change once a person calms down.
The next thing we need to ask about is allergies. If someone has an allergy to some medication or is allergic to any insect, we have to inform the doctor. We don’t need to find out what kind of allergy it is (bee sting or pollen allergy, etc.) because it is our doctors’ job to find out all these things. So asking “do you have an allergy?” and writing down their answer will do.
Tell us all the medications they take regularly. If there is a long list of medicines, including supplements and vitamins, write them down in the chart whether they are over-the-counter medications, prescription drugs, home remedies, or street drugs. This information will be helpful for both diagnosing and treating patients correctly and also for preventing any complications from occurring.
PREVIOUS RELEVANT MEDICAL HISTORY
Is one of the most important points to ask as a first-aid responder. In this section, we have to write down all symptoms that the patient had suffered in their life, which are related to current symptoms or accidents. For example, if someone has a head injury and says, “I feel something strange on the right side of my head.” We should also note down “headache” because headaches may signify the brain’s bleed though it isn’t diagnosed yet. Or if someone says that their leg was severed from the hip, we should take down this point into our chart because if thigh pain develops after some time, it tells us about deep vein thrombosis.
LAST ORAL INTAKE
It’s important to keep in mind all the medications and food they took before and after the accident. It is helpful for doctors because we don’t know what is happening with patients right now, but if we move in this direction, we can solve many things. For example, if someone consumed alcohol two hours ago, it will show up in a blood test even though there are no other signs/symptoms of alcohol consumption.
Helps us find out how the accident took place and who was there during the accident. Commonly, we can find out things regarding accidents from bystanders or witnesses. Still, it’s important to know the exact time and place because sometimes people get confused and don’t give accurate information. So ask, “what were you doing five minutes ago?” and “where were you standing when this happened?”
HOW TO PERFORM STEP BY STEP?
STEP 1: Ask the casualty if they are experiencing any pain or discomfort. If the casualty reports a painful or uncomfortable condition, then this becomes the primary survey finding.
STEP 2: List all of the signs & symptoms that you observed during your assessment. If you suspect an injury or illness based on your findings in #1 above (a painful or uncomfortable condition), then determine whether these signs and symptoms are due to injury (it hurts here) or illness (I don’t feel well). Signs & symptoms may include hiccups, rashes, pain, nausea/vomiting, abdominal cramps/discomfort.
STEP 3: Write down any known allergies the casualty has for drugs and food. If you suspect an injury or illness based on your findings in #1 above (a painful or uncomfortable condition), ask the casualty if they are allergic to any medications or foods. If yes, what are they? Are there any reactions you have had to them? What medication are you taking right now?
STEP 4: Ask about the previous relevant medical history of your casualty. Please do not neglect this step because it is often overlooked. For example, if a casualty knows they are asthmatic, it would be important to explore what medication they are taking for asthma and whether they have an inhaler with them right now. Be sure to ask about relevant medical history such as:
1. Last known well time.
2. Any surgeries in the past
3. Allergies to medications or food
4. History of fainting or seizures
5. Recent illnesses or fevers
6. Family members with certain illnesses
STEP 5: Ask about the last oral intake of your casualty. Ask about:
last known normal bowel movement time
any vomiting/diarrhea since this symptom is very important to document as it can indicate dehydration and shock, both life-threatening conditions. Also, be sure to determine when their most recent bowel movement was so you could assess whether there may be blood in their stool from any recent GI bleeds or trauma from a prior fall or car accident. See the sample assessment form below.
STEP 6: Ask the casualty what happened before you arrived on the scene (if applicable) and how they got hurt or ill and if they remember any details of the event. This information helps for the future care of the patient by providing useful information such as whether there was a fall, gunshot wound, trauma from a motor vehicle accident, etc. that relate to specific injuries of the head, spine (neck), chest, or abdomen that would require special handling of these areas during your primary survey.
STEP 7: Ask the casualty if they have a pain level of 1-10, where ten is the worst. This helps to establish a baseline so you can assess any improvement or worsen of pain down the road. You can also ask what time their last dose of pain medicine was taken to evaluate whether there has been enough time for that medication to work and how long it typically takes for them to get relief from taking it. Sometimes patients need more than one dose per day.
An ED triage form is a tool commonly used in an emergency department, particularly in larger hospitals. Here is a simple example form you could use outside a hospital setting. It covers all the steps above and gives you space to check what injuries or symptoms your casualty may be exhibiting. It is often difficult for non-medically trained personnel, such as police officers or firefighters, to quickly assess an injured/ill patient and accurately collect the right information under stressful circumstances. This form can help eliminate that pressure by making medical assessment easier for one person to complete without extensive medical training.