Signs and symptoms
Ask what the patient feels and identify what you can observe. Clarify the chief complaint before moving on.
How → Why → Practice
Ask useful questions, recognize important answers, and document a focused history.
Use SAMPLE to gather information that changes assessment, treatment, transport priority, or destination decisions.
0 of 3 lessons complete
Lesson 1
HOW: Obtain a SAMPLE history
Ask one clear question at a time, listen to the answer, and follow up on anything that changes care.
Allergies
Ask about medication, food, environmental, and latex allergies. Document the reaction whenever possible.
Medications
Ask about prescriptions, over-the-counter drugs, inhalers, insulin, anticoagulants, and recently missed or changed doses.
Pertinent history
Ask about medical problems, surgeries, pregnancy, prior similar episodes, and baseline function relevant to today’s complaint.
Last oral intake
Ask what and when the patient last ate or drank. Include alcohol, medications, and other substances when relevant.
Events leading up
Ask what happened before symptoms began, what the patient was doing, and how the condition has changed.
Do not treat SAMPLE like a script
Change the order when needed. Life threats, pain, respiratory distress, altered mental status, and scene conditions may require immediate intervention before a complete history.
Useful follow-up questions
- What reaction do you have to that allergy?
- When was the last dose taken?
- Is this normal for the patient?
- Has this happened before?
- What changed immediately before symptoms?
Common mistakes
- Accepting “none” without clarification
- Listing medications without their purpose
- Ignoring anticoagulants or insulin
- Failing to ask a caregiver or witness
- Documenting conclusions instead of answers
Lesson 2
WHY: Understand why the history matters
SAMPLE helps explain the current findings, reveals risks, and identifies information that may change treatment or transport.
Allergies need reactions
“Allergic to penicillin” is incomplete. Rash, nausea, swelling, and anaphylaxis have very different implications.
Medications reveal disease
Medication lists may identify hidden conditions, treatment risks, overdose possibilities, and adherence problems.
History changes risk
Anticoagulants after a fall, pregnancy with abdominal pain, or insulin with altered mental status can immediately raise concern.
Events create context
Exertion, trauma, heat exposure, missed meals, new medication, or substance use can connect symptoms to a likely cause.
History itemExampleWhy it matters
Allergy reactionFacial swellingRaises concern for severe hypersensitivity
MedicationApixabanIncreases bleeding risk after trauma
Past historyDiabetesSupports glucose assessment with altered status
Last intakeNo food since yesterdayMay contribute to weakness or hypoglycemia
EventsSymptoms began during exertionMay increase concern for cardiac or respiratory cause
Knowledge check
Full scenario mode: complete this assessment for the active patient. Teaching sections and patient changes are locked until you leave the scenario.
Lesson 3
PRACTICE: Gather, interpret, and document
Interview a randomized patient, reveal the SAMPLE answers, decide whether the history contains important abnormal or high-risk information, and document it clearly.
Randomized patient
Patient encounter
SAMPLE history
Practice feedback