SAMPLE
Focused History for Acute Presentations
The rapid-fire history for triage and pre-procedure workups.
On the AANP exam, the rapid focused history for an acute presentation lives in SAMPLE — designed for EMS but used in any triage, pre-procedure, or rapid response setting. Symptoms (chief complaint), Allergies (drugs, latex, food), Medications (current, including OTC and supplements), Past medical history, Last oral intake (food and drink, with timing), Events leading up to presentation. Last meal and event timing matter for surgical planning and toxic ingestions. AANP exam vignettes use SAMPLE to test what you should already know before ordering a procedure or starting treatment, and the right answer is usually the data point you forgot to collect.
- SSigns / SymptomsChief complaint — what brought them in right now?
- AAllergiesDrugs, food, latex. Clarify reaction — rash vs. anaphylaxis changes decisions.
- MMedicationsCurrent meds, recent changes, OTC, herbals. Ask about doses, not just names.
- PPast medical historyPertinent conditions, surgeries, hospitalizations.
- LLast oral intakeCritical for surgical candidates — NPO status guides anesthesia timing.
- EEvents leading upMechanism of injury; symptom progression; environmental exposures.
Clinical Context
Originally from EMT training, now universal for triage, ED handoffs, and pre-procedure assessments. Pairs naturally with OPQRST when pain is the chief complaint.
The "L" (last oral intake) is a surgical-candidate trip-wire the AANP loves to test — elective surgery is delayed if the patient has eaten recently. The "E" (events) is where mechanism of injury lives (fall from how high? head strike?) and where preceding illness context lives (flu symptoms for 3 days before the ED visit).
Related Mnemonics
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