Alicia’s Test

Sample

100

A in sample

Allergies. Ask the person if they are allergic to anything

200

M in sample

Medications. Ask the person if they are taking medication

300

S in sample

Signs and symptoms. What do you notice (bleeding, skin color, pain or breathing problems)

400

L in sample

Last oral intake. When did they last eat? What did they have? (Important for low blood sugar)

500

E in sample

Events leading up to incident. How did this occur? (Important in trauma situation and for giving clues on what injury to look for MOI)

Sample contd

100

P in sample

Pertinent past medical history. Look for medical tag

Anaphylaxis

100

specific SAMPLE notes

A in SAM

Allergies

200

specific sample notes

M in SAM

Medications. Ask if they have epi pen

300

Specific sample notes

S in SAM

Signs and symptoms

Skin reactions (hives and flushed skin)

hypotension (low blood pressure)

constriction of airways

weak and rapid pulse

dissiness or fainting/syncope

400

How to administer an epipen

Hold the pen in the middle (dont touch either end)

remove safety cap

press tip of injector hard against midpoint of thigh

hold for 10 seconds

massage for 10 seconds

second dose 5-15 min if no improvement

Choking infant

100

Sample notes

S 

Signs and symptoms

unable to talk or cough

cyanosis

200

Steps to CPR

Hold infant facedown in forearms, legs on either side (support head and jaw with your hand)

give 5 back slaps between the infant’s shoulder blades with the heel of your others hand (infant head lower than feet)

turn infant over on back and check airway

If still obstructed give 5 chest thrusts using two fingers on sternum at nipple line

repeat until alleviated or unresponsiive

300

Infant CPR

Call 911 on speaker (ask for AED)

check for responsiveness, breathing, and pulse

pulse over 60 bpm or absent start compressions at 100-120 per min

after each compression set open airway check for obstruction (remove before giving two breaths)

Adult CPR

100

Sample notes

Signs and symptoms

person is holding throat

person unable to talk or cough

ask the person are you choking can i help you

200

CPR steps

Stand or kneel behind the person and wrap your arms around the persons wait (fists in front)

make a fist with one hand and put it thumb side slightly above the person umbilicus away from sternum

grasp the fist and give quick upward thrusts into abdomen

continue until resolved or unresponsive