"It Didn't Go So"

"It didn't go so," she said under her breath. —Erna Brodber, Myal, p.84.

SAMPLE training sheets - 30 Apr 2016 19:21

Tags: first-aid how-to protest training

I got these SAMPLE practice sheets from a training Sophia wrote for Chicago Action Medical around 2003ish. She may have gotten them from Black Cross Health Collective or may have written them herself. I love to use them for teaching students how to take a patient history. A fragment from one of my training outlines from 2013 is in this post below the practice sheets.

Besides seeing the utility of SAMPLE and learning the acronym, an objective I always have when teaching SAMPLE is to encourage students to suspend forming an opinion; to live in the question, not the answer.

Finally, I remind students to trust the people they help. Often this interview helps chronic illness sufferers or people with disabilities remember what they need to do. They are already the experts on their conditions! We assist them in locating the problem with SAMPLE. After they decide on an course of action, we may assist them in carrying out their plan.

In affinity group medic (AGM) trainings, I encourage students to talk with their affinity group members confidentially about members' allergies, medications, and past pertinant medical history before an action. This establishes knowledge that can help the AGM be a better wellness buddy, and also establishes trust. If you can keep group members' confidence before they're hurt, they'll trust you more later when they're hurt and scared.


S: Shortness of breath.
A: None.
M: Inhaler for asthma.
P: Diagnosed with asthma at age 15; no other medical problems.
L: Had nothing to eat today.
E: Running from cops; scared.


S: Headache around eyes.
A: Sulfa drugs.
M: Takes birth control pills.
P: Got hit on head one week ago, had a wrist fracture one year ago.
L: Nothing to eat today; has been drinking coca cola and water and peeing "a lot."
E: Went out on blockade at 7 AM; slept 3 hours last night.


S: Nausea and diarrhea.
A: Milk, nuts.
M: Epinephrine for allergic reactions.
P: Nut allergic reaction about 6 months ago; had to go to hospital.
L: "Shitting every 15 minutes," has not vomited; ate big chicken dinner last night but nothing today.
E: Chicken dinner; just been hanging around convergence center all day.


S: "Sprained" wrist with pain (hurts to move it).
A: None.
M: None.
P: Broke same wrist in 1996.
L: Ate oatmeal and drank tea about 2 hours ago, went to toilet a few minutes ago.
E: Fell on wrist, running around in crowd.


S: Fell down, dizzy, feel hot.
A: Aspirin.
M: Seizure medications.
P: Seizures since age 23.
L: Ate breakfast today at 8 AM, lunch at noon, went to toilet an hour ago.
E: Stood in sun at rally for about 6 hours now.


S: Itching on abdominal area.
A: Hay fever.
M: Homeopathic pills for hay fever.
P: Skin condition "with a name I donÕt recall" that cleared up with medication in 2003.
L: Ate pie for breakfast, drank coffee and later tea.
E: Used special soap meant to take oil from skin as protection from tear gas.


S: Drunk, dizzy, nauseous.
A: None.
M: "Just the whisky!"
P: "I drink all the time!"
L: 12 drinks in 3 hours, ate a pizza 2 hours ago, urinating constantly.
E: "Just felt like partying after the big riot."


S: Chest pain, with 'acidic' feeling.
A: None.
M: Rheumatoid arthritis medications.
P: "I have heartburn," denies history of heart problems.
L: "Deep fried Mars Bars" and a pizza for lunch today, no dinner yet, drinking water.
E: Ate about 60 minutes ago; no other events since then.

SAMPLE patient history

Refer students to SAMPLE on chart paper—students must see SAMPLE, not just hear it.

Facilitator says: Sometimes the SAMPLE history is over quickly. Sometimes it is a time consuming and detailed interview that begins in the first few moments of patient care and continues until you walk through the doors at the emergency room. Good SAMPLE histories can be disorderly and divergent. They go off on tangents. They explore deeper than the basic questions. They encourage the patient to talk and elaborate when the patient is able.

S: for Symptoms.
A: for Allergies.
M: for Medications.
P: for Past medical history.
L: for Last food and drink (and last shit and piss).1
E: for Events.

Facilitator says: Run through SAMPLE in your head every time you take a history to make sure you cover all your bases, even if you ask questions out of order. Memorize this acronym.

Trainers model SAMPLE and debrief

Facilitator says: Let's see what we can learn by taking a SAMPLE history.

3 students: volunteer. Each gets a Reader opened to Sophia's SAMPLE practice sheets. Each student gets to pick which patient they want to be without telling trainers.

Trainer buddy pair: interviews each student sequentially in front of class.2

After each interview, facilitator asks class: What did you learn about (patient's name) from the SAMPLE history? What do you still want to know?

Students model SAMPLE and debrief

6 more students: volunteer. They come up in front of the class in pairs and each of 3 students playing medics interviews each of 3 students playing Sophia's patients.

After each interview, facilitator asks class: What did you learn about (patient's name) from the SAMPLE history? What do you still want to know?

OPQRST pain history

You don't get much information by asking, "What are your symptoms?" There are lots of good questions for zooming in on the chief complaint. The most useful a string of letters from later in the alphabet.

O: for Onset.
P: for Provokes/Palliates.
Q: for Quality.
R: for Region/Radiates/Refers.
S: for Severity (1-10).
T: for change over Time. - Comments: 0

Scene safety training exercise - 30 Apr 2016 15:58

Tags: first-aid how-to protest training

This training exercise is based on the way that a long-time member of Chicago Action Medical mentors new medics when they buddy with him. As they walk around a protest, he asks questions like the ones below. One of his buddies suggested we drop most of our scene assessment lecture and replace it by assessing the actual scene (with some added imaginary elements) around the sketchy locations we hold trainings.

Actual scenes students have walked through at trainings I've led include loading docks, blind alleys, razor wire-topped fences, broken glass, no running water or handwashing stations, broken water filtration (contaminated water source), high-speed busy roads, dangerous banner drop locations, bus shelters, children and people with extremely limited moblity, and an approaching wildland fire. At several trainings, students used their breaks to control risks they had identified.

The below training text is from a 2013 training in the Piedra Wilderness Area of Colorado. It is not the whole Scene Assessment section, just the "good parts." Since 2013, I've used this exercise with modified questions in St Louis, Chicago, and Atlanta. It's always a hit!

Introduction to scene assessment

Facilitator says: Watch surroundings and communicate.

  • Look for danger.
  • Make the scene safer.
  • Be prepared for the scene to change.

Facilitator says: Scene assessment encompasses a lot of continuous observations:

  • Personal (Ethan’s here, he gets seizures).
  • Specific (the baby bloc pushing strollers is right next to the Commie bloc chanting about shooting Obama).
  • Big picture (open businesses, street grid, weather).

Facilitator says: Always assess scene and stay situationally aware—especially when things seem calm and no one is injured.

Practice communicating about a scene

Facilitator says: We’re going to practice doing scene assessment as medic affinity groups here at camp. An experienced medic will walk around camp with each group, and guide you to see the scene.

Proctors: identify selves.

Students: break into as many groups as there are proctors.

Facilitator says: before you head out, answer these questions:1

  • Who are the organizers and logistics people at this camp?
  • Is there cell reception in camp?
  • Who has a charged phone?
  • What is the local emergency number for medical/trauma emergencies? What resources exist for someone in camp who needs help with sexual/domestic violence, STI/blood-borne illness testing/treatment, mental health crisis, poisoning, or addictions recovery support?
  • If you call 911, what hospital will someone end up at?
  • What is our camp evacuation route?
  • How long would it take to evacuate one limping (assisted) or unresponsive (carried) person to a rendezvous point? All the way to definitive care?

Groups: Go assess the scene around the training location for 10 minutes. As they walk around, their proctor asks Dick Reilly-style questions like these:

  • Where are your exits?
  • Where are your treatment areas?
  • Where are the police?
  • Where are their bosses?
  • Where are the legal observers?
  • Where are children and elders?
  • Could the weather change?
  • Who is most at risk here and why?
  • What are the biggest dangers here and why?
    • What are choke points?
    • Obstacles for panicked crowd?
    • How can we calm crowd?
  • What is the state of food, water, and sanitation?
  • Where are alcohol and intoxication clustered?
  • Where can someone go to get away from all alcohol and intoxication all night?
  • Where can someone shelter-in-place out of weather?
  • How can someone leave camp to get care or go home?
  • If "…," then what would you do?2
  • If "…," who would you involve, where would you refer the person, or who could improve the situation?


Facilitator asks: How did communicating about the scene as a group change your individual perception of it?

If your team sees injured protesters

Facilitator says: Look for danger/needs/resources. Stop to decide plan and activate back-up. Scene assessment continues while your buddy team:

  1. Exits the scene,
  2. Uses available resources to control scene (but does not assesspatient or provide care),
  3. Or controls scene, engages patient, prepares to do advocacy.

Calling 911 to activate EMS

  • Know location; In city: exact address if possible, at least cross streets. In backwoods: know name of your area, directions to road-accessible rendezvous point, nearest highway mile marker, GPS coordinates.
  • If you’re a medical professional, identify your title, cert or shield number for authority drag purposes (or choose to remain anonymous).
  • Say patient’s chief complaint (if known). Follow dispatcher’s lead. Stay on phone. Response time depends on 911 dispatcher’s assessment of urgency and availability of responders.

Scene control options

Get to a safer scene by foot, car, transit, cab, or ambulance

  • Get out of cold, rain, wind, or heat.
  • Help someone back up from a fight
  • Get to wellness center or hospital.

Stay put; make scene safer around you

  • Calm, comfort, reassure: Sometimes the scene is safe but the injured person is so hyped he doesn’t recognize it is safe.
  • De-escalate and redirect hostile/nosy bystanders: Use humor, give something to do, be polite, firm, and cheerful.
  • Create privacy circle. - Comments: 0

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