6.3 SAMPLE and OPQRST Interviewing

SAMPLE and OPQRST: Ask Questions That Change Care

Interviewing is part of secondary assessment, but timing matters. A stable patient with chest discomfort, abdominal pain, shortness of breath, allergic reaction, seizure history, or injury can provide high-value information. An unstable patient may only allow a few critical questions before transport-capable EMS or advanced resources take over.

SAMPLE is a memory tool for history. It stands for signs and symptoms, allergies, medications, past medical history, last oral intake, and events leading to the illness or injury. It is not a script that must be asked in perfect order. Use it to avoid missing important categories.

SAMPLE and OPQRST Quick Table

OPQRST is often used for pain, but it can also help describe breathing discomfort, headache, dizziness, or other symptoms. Onset asks when it started. Provocation asks what makes it better or worse. Quality asks what it feels like. Region and radiation ask where it is and whether it spreads. Severity asks how bad it is. Time asks whether it is constant, changing, or recurrent.

Keep questions short. A patient in respiratory distress cannot answer a long interview. Ask yes or no questions when needed. Let the patient choose a position of comfort while you gather essentials. If the patient is unable to answer, ask family, caregivers, witnesses, or facility staff, but continue to protect patient privacy.

Medication clues matter. Inhalers, nitroglycerin, diabetes supplies, seizure medication, blood thinners, epinephrine auto-injectors, and medical alert jewelry can shape the handoff. The EMR should report the finding and follow local protocol for any assistance with medications. Do not improvise medication use outside authorization.

Allergies are not limited to medications. Food, latex, insects, and environmental exposures can matter, especially in a possible allergic reaction. Ask what happened during prior reactions if time allows. Trouble breathing, swelling, hives, or altered mental status after an exposure should raise concern.

Events leading to the call can reveal mechanism and timing. A fall from standing is different from a fall from a roof. Chest pain that started at rest is different from pain after lifting a box. Stroke-like symptoms need time information such as when the patient was last known well.

For exam questions, the best interview answer is usually targeted. If a breathing patient has a prescribed inhaler, that is relevant. If a trauma patient has anticoagulant use, that is relevant. If a patient is unstable, the correct choice may be to ask only the most time-sensitive question while continuing urgent care.