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view that is a better use of limited time than front-loaded SAMPLE, but still consistent with the philosophy of primary and second- ary assessment: • Spend the first minute discovering what you need to know to make treatment decisions. • Finish the interview en route while assembling a background-rich presentation you'll give the receiving facility. The Nonemergent Patient A distinctive aspect of working in a nontra- ditional EMS environment—entertainment, in my case—is that many patients present with nonemergent conditions that make transport less of a priority and permit more comprehensive interviews. As our industry assimilates the com- munit y-paramedicine paradigm, we' ll hear more and more vague complaints with subtle clues like mild pain or minor GI upset. A willingness to go into detective mode and conduct an unhurried interview, for the sake of both diligence and customer service, should be as much a part of our prehospital practice as rapidly treating and transporting unstable patients. A good way to proceed during interviews with nonemergent patients, many of whom have multiple chronic illnesses, is to pro- gressively update an "inventory" of their complaints. For example, "Any discomfort besides your headache and sore knee?" shows you understand what the subject told you so far, and are considering that there is more useful information to come. Prompts like "discomfort" or "odd feelings" are more open-ended than "pain"; to some people, a sensation such as chest pressure isn't pain. Don't hesitate to clarify answers to your questions. A patient whose head "feels funny" might have a cold or an intracranial bleed. Sometimes friends or family mem- bers can help patients answer questions, but beware of bystanders who repeatedly interrupt your interview. Ask them to let the subject try to answer. Even better, put them to work doing something useful, like collecting the patient's meds. Summary As community paramedicine and other nonemergent initiatives become common - place in EMS, caregivers are going to need communication skills that go beyond SAM- PLE checklists. A minimalist approach to dialogue with patients, considered preferred if not essential in what was once almost exclusively a light-and-sirens environment, isn't acceptable when prehospital interven- tions require a thorough understanding not only of chief complaints, but also how the physical part of illness and injury is framed by the patient's environment. Be considerate, be as thorough as time permits, and pay attention! Next time we'll talk about interviewing prospective employees. EMSWORLD.com | OCTOBER 2015 31 Gainful employment information available at ColumbiaSouthern.edu/Disclosure. EMERGENCY MEDICAL SERVICES PROFESSIONAL DEVELOPMENT OPPORTUNITIES IN TO HELP YOU GAIN NEEDED FOR SUCCESS. THE KNOWLEDGE AND SKILLS CSU OFFERS ADVANCE YOUR CAREER AND TAP INTO YOUR POTENTIAL TODAY! TO LEARN MORE ABOUT OUR TRAINING, WORKSHOPS, CEUs AND ONLINE DEGREES, VISIT ColumbiaSouthern.edu/EMSworld or call 877.258.7153 BACHELOR'S IN EMERGENCY MEDICAL SERVICES ADMINISTRATION TEXTBOOKS INCLUDED For More Information Circle 26 on Reader Service Card