Casualty History/SAMPLE
As a first aider, one of the most important tasks you will perform is taking a casualty history. This involves gathering information from the casualty about their medical history, allergies, medications, and any recent illnesses or injuries that may be relevant to their current condition. The use of the acronym SAMPLE can be helpful in guiding your questioning and ensuring you obtain all the necessary information.
SAMPLE
Signs and symptoms
Allergies
Medications
Past medical history
Last oral intake
Events leading up to the incident
Let’s break down each element of the SAMPLE acronym in more detail:
Signs and symptoms:
Start by asking the casualty to describe their current symptoms. Are they experiencing any pain, discomfort, or difficulty breathing? Have they noticed any changes in their body or behavior? This information can help you assess the severity of the situation and determine the appropriate course of action.
What are the signs you can see? Are they suffering from cyanosis? Is their breathing rate slow? Once you have all of their signs and symptoms, it’s much easier to treat a casualty.
Symptoms are what a casualty feels, whereas signs are what you can see. Below is a table of common signs and symptoms.
Signs
Signs could include:
Pale skin or pale skin inside the lips
Cyanosis (bluish tint to skin, lips or nails)
Flushed skin
Fast, slow, weak or irregular pulse
Abnormal Breathing
Smell (such as alcohol)
Swelling
Deformity
Spurting blood
Symptoms
Things you can ask the casualty include:
Are you in pain?Where is it?
Can you describe what it feels like?
Does anything make it worse/better?
When did it start?
How severe is it?
They may feel:
SickDizzy
Hot or cold
Hungry or thirsty
Allergies:
Ask the casualty if they have any allergies or hypersensitivities to medication, food, or environmental factors such as pollen or animal dander. Some allergies are will known; peanuts, wasp stings or shell-fish. Some are less well known. If the patient replies with: “Yes, Erythromycin”. Do you need to know what that is? No.
Firstly, no one is expected to have a knowledge of all medical conditions, let alone a First Aider. Secondly, we may not necessarily need to act on this information; if this information means nothing to us, we pass on what we have found so someone else can act on them. Note the specific allergen and the symptoms they experience when exposed to it. This information is critical for preventing further harm to the casualty and ensuring appropriate treatment is administered.
Good questions lead to better questions.
If they are allergic to wasp stings, have they been stung?
If they are allergic to nuts, have they eaten recently?
Does it usually feel like this? What do they usually do?
Medications:
Ask the casualty if they are taking any medication, both prescription and over-the-counter. Note the name of the medication, the dosage, and the frequency of administration. This information can help you determine if any medications may be contributing to the casualty’s symptoms or if they need additional medication to treat their condition.
Good questions lead to better questions. If someone was to say they regularly take a particular medicine, further questions may be:
What is that for?
How long have you been taking it for?
Do you need it now?
Do you have it with you?
When did you last take it?
Past medical history:
Ask the casualty if they have any past medical conditions or surgeries, and if so, note them. Also, inquire about any family history of medical conditions, as this may be relevant to the casualty’s current condition.
No one really wants to know about the casualty’s fungal nail infection or that they had their tonsils removed when they were 12, but is there anything ongoing that might be relevant.
With injuries;
Is this a recurring problem (such as back pain) or is this a new event?
Is this a new injury or have they aggravated an existing injury?
Have they had any surgery in that area?
With illnesses;
Is this something they have had before?
Do they have any medication for it (see above)?
Could their injury (a fall) be related to their illness (hypoglycaemia)?
Last oral intake:
Could their condition be caused from low blood sugar? If it is not a case of low blood sugar because they tell you they have recently eaten, what did they eat, how much and when? Have they been to the toilet?
This information is particularly important if the casualty is experiencing nausea, vomiting, or abdominal pain, as it can help determine the cause of their symptoms and the appropriate course of action.
Events leading up to the incident:
What happened? This alone can help you build up a bigger picture. Ideally get this information from the casualty if they are able to. If not, get it from bystanders but beware; bystanders have a tendency to embellish so listen to what they are saying, look at the scene around the casualty and look at the casualty to build up a representative picture.
Did the casualty experience an injury, fall, or accident? Did they suddenly develop symptoms or did they worsen over time? This information can help you determine the cause of their condition and the appropriate course of action.
How to ask these questions
SAMPLE is a prompt, it’s not a script. Do not feel you have to ask these question in the SAMPLE order, nor do you need to use these words. Try to ask the questions in a conversational manner, possibly whilst you are treating the casualty or preparing your equipment. An example of how you could do this is:
As you approach, ask: “What happened here?” [E – Events]
You could follow it up with “And how are you feeling?” whist looking for any signs [S – Signs & Symptoms]
“Has this happened before?” [P – Past medical history]
“Are you taking anything for that or any medication in general?” [M – Medication]
“When was the last time you ate? What was it?” [L – Last oral intake]
“Do you have any allergies?” [A – Allergies]
Other considerations
In addition to the SAMPLE acronym, it is also important to ask the casualty if they have any relevant information they would like to share. This could include any concerns or fears they have or any additional information about their medical history that may not have been covered by the SAMPLE acronym.
Be careful of asking leading questions which influence the casualty such as “I bet it’s painful, isn’t it?” or “You’re eating properly, aren’t you?”. It also best practice to get the questions out of the casualty early. Once the casualty goes unconscious you have lost your opportunity. Even if the answers aren’t particularity revealing (“No, it’s never happened before, I don’t have any allergies and I’m not on any medication”) at least you now know this rather than assuming and this information is also passed on.
Taking a thorough and accurate casualty history is crucial for effective first-aid treatment. It can help you assess the casualty’s condition, determine the appropriate course of action, and provide important information to medical professionals if necessary. Remember to use the SAMPLE acronym as a guide and to ask the casualty if they have any additional information they would like to share.