The S.A.M.P.L.E. mnemonic is a standardized method used by first responders and lay rescuers to collect a comprehensive patient history during a medical emergency. This structured tool is designed for use after initial life-threatening issues have been addressed, especially when the patient is conscious or a reliable bystander is present. Gathering this background data is an important part of the secondary assessment, helping to paint a detailed picture of the patient’s overall health and the circumstances leading up to the current situation. This systematic approach ensures that practitioners do not overlook relevant medical details that could influence treatment decisions or assist arriving emergency medical services (EMS).
Identifying the Immediate Crisis: Signs and Symptoms
The first letter, ‘S,’ stands for Signs and Symptoms, which are the immediate indicators of the patient’s current medical state. Signs are objective observations the rescuer can see, hear, smell, or feel without the patient needing to report them. Examples of signs include visible bleeding, swelling, pale skin color, irregular breathing, or the presence of a rash.
Symptoms, in contrast, are the subjective experiences the patient reports about how they feel, such as pain, nausea, dizziness, or blurred vision. Since symptoms are internal and cannot be directly measured or observed, they require the patient to be alert enough to communicate their discomfort. Asking specific questions about the location, severity, and quality of pain helps clarify the nature of the crisis and guides the prioritization of care.
Gathering Critical Medical Background: Allergies, Medications, and History
Allergies
The next three letters—’A,’ ‘M,’ and ‘P’—collect pre-existing medical information relevant to the current emergency. ‘A’ is for Allergies, covering adverse reactions to medications, foods, and environmental factors like insect venom or latex. This information is important because exposure to a known allergen can trigger a severe, life-threatening reaction such as anaphylaxis, which requires immediate and specialized treatment. Knowing about a drug allergy prevents the administration of a treatment that could cause further harm.
Medications
‘M’ stands for Medications, which includes all prescription drugs, over-the-counter medicines, vitamins, and herbal supplements the patient is taking. This list provides insight into the patient’s baseline health and any chronic conditions they are managing. Certain medications can interact dangerously with emergency treatments or mask symptoms, making it important for responders to know what is already in the patient’s system. It is also helpful to know the dosage and last time a dose was taken.
Past Pertinent Medical History
‘P’ refers to Past Pertinent Medical History, which encompasses previous illnesses, injuries, chronic conditions, and surgeries that may complicate the current situation. A history of heart disease, for example, makes chest pain a much more serious concern. This historical context helps first responders determine if the current issue is a new event or a complication of an existing health issue. Focusing on pertinent history means prioritizing conditions like diabetes or asthma over less relevant past injuries.
Understanding the Incident Context: Last Intake and Preceding Events
Last Oral Intake
The final two letters, ‘L’ and ‘E,’ establish the immediate timeline and circumstances surrounding the incident. ‘L’ is for Last Oral Intake, which asks when the patient last ate or drank, and what they consumed. This detail is important because a lack of food can lead to hypoglycemia, especially in a diabetic patient. Knowing the last intake is also important information for hospital staff if the patient requires emergency surgery or anesthesia, as a full stomach increases the risk of aspiration.
Events Leading Up To
‘E’ stands for Events Leading Up To the incident, which seeks to establish the mechanism of injury or the progression of illness symptoms. For a trauma patient, this involves understanding the exact sequence of events, such as falling from a specific height. In cases of medical illness, the rescuer asks about how the symptoms started and how quickly they intensified, providing a timeline of the illness’s onset. This context helps distinguish between a sudden event and a gradual one, which directs both immediate care and subsequent medical assessment.