armywifeemt
Forum Lieutenant
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What is the single most important question to ask in the SAMPLE history?
There are a few ways of looking at this, but I am going to go off of the literal meaning of the OPs initial question. He asked about SAMPLE specifically.. yes, it is a tool, a guide, and not something you will rely on for every call, especially as you gain experience... but if it weren't useful, we wouldn't learn it. As far as the most useful question, I personally think in most hypothetical situations it would be Medications... It seems to me that you could probably get answers to a lot of the other questions in SAMPLE just by asking about medications, especially if you know your pharmacology. You have a very good chance of finding out about allergies and pertinent medical history from medications... and depending on what you were dispatched for and how much information you got from dispatch, it might give you a strong indication as to what is going on. For instance... dispatched for a patient who is "acting funny" at work, and the coworkers told dispatch that their consciousness had been slowly deteriorating all day... you get there, have a barely conscious patient (situation such as what I quoted from mycrofft below) and ask them if they take any meds... say they're taking insulin... Good indication that it might be time to get a BS read and give them some glucose.
The only problem with this whole question, especially mycroffts rephrasing of it is that the majority of the real calls we get will give us different contextual hints. So many clues on scene guide the questions you ask... and even the nature of the call. I mean responding to an MVA you're usually going to be automatically suspecting shock... possibly inebriation, especially between midnight and 5 AM... responding to a patients house, you may have medication bottles laying all over the place, or alcohol, or even drug paraphernalia. It is hard to really determine one important question.. some patients you might not even get to ask questions.. So, yeah, hypothetically you may be able to come up with an answer to this question, but in reality, there really is no one right answer.
Allowing for time for the increasingly obtunded pt to think then reply, NOW tell us what the most important question(s) is/are.
Honest answers to these could be a real psychological test.