Required before first use

Training aid only — not a medical device or ePCR

NarrativeCoach is an educational PWA for practicing EMS narrative writing on fictional scenarios.

It is NOT:
• a medical device, clinical decision support, or protocol authority
• a NEMSIS / agency ePCR or legal/billing advisor
• CAPCE / CE credit (no CE claims)

NEVER enter real patient names, addresses, DOBs, MRNs, or other PHI.

All scenarios are fictional and watermarked TRAINING SCENARIO.

Scoring uses a deterministic rubric. AI feedback is disabled by default (ENABLE_AI_FEEDBACK=false). Do not send PHI to language models.

You are responsible for following your agency policies, medical direction, and applicable law when documenting real calls (use your agency ePCR — or a field builder like HandoffNote — not this trainer).

TRAINING SCENARIO

fall · medium

Elderly Ground-Level Fall

Fictional ground-level fall. Document mechanism, injuries, anticoag if present.

Never enter real PHI. Drafts stay on-device (IndexedDB). No LLM forwarding. Not a medical device / ePCR.

Learn the bar

Sample narrative

Excellent SOAP example for this fictional drill · scores 100 (Defensible)

View sample

TRAINING SCENARIO

Study the structure, quotes, times, negatives, and response — then write your own from the call sheet. Do not paste this as your scored draft.

TRAINING SCENARIO — S: 81 y/o female, estimated 61 kg, English-speaking, GCS 15 / AOx4. Historian: Patient and home health aide (found her). Patient/historian stated "I tripped on that rug. My right hip is killing me. I did not pass out." Chief complaint: Right hip pain after a ground-level trip. Onset: Sudden at 11:30 when she tripped. Provocation/palliation: Worse with any attempt to move the right hip; better lying still. Quality: Sharp, deep hip and groin pain. Radiation/location: Right groin and anterior thigh; no back radiation. Severity: 7/10 on scene; 4/10 after fentanyl. Time/duration: Continuous since the fall. Signs/symptoms: Right hip pain, unable to bear weight, no headache, no chest pain. Allergies: Sulfa (rash). Medications: Warfarin 4 mg nightly; metoprolol 25 mg; vitamin D. Past medical history: Atrial fibrillation on anticoagulant; osteoporosis; prior left wrist fracture. Last oral: Breakfast 08:00; last warfarin last night. Events: Walking to kitchen, caught toe on rug, fell onto right side, aide heard the fall and called 911. Pertinent negatives: no loss of consciousness; denied chest pain. This TRAINING SCENARIO includes fall, hip, anticoagulant. Care included spinal motion restriction consideration, splinting, pain management.

O: Location: Apartment living room, throw rug at hallway junction. Scene: Aide on scene. Patient on the floor, right hip, alert and in pain. Trip on a bunched rug. Furniture not moved. No pets. Well-lit. BLS and engine crew present.. Exam: AOx4; no scalp hematoma; pupils equal; C-spine nontender, no midline thoracic/lumbar pain; Right leg shortened and externally rotated; PMS intact right foot: pulse 2+, sensation present, wiggles toes; Pelvis stable to gentle compression; abdomen soft; No other obvious deformity. Serial vitals: 11:48 BP 142/78 HR 88 irregular RR 18 SpO2 97% RA; GCS 15, pain 7/10, skin warm, dry. 12:05 BP 138/76 HR 84 irregular RR 16 SpO2 97% RA; GCS 15, pain 4/10.

A: Working impression for this TRAINING SCENARIO: Elderly Ground-Level Fall — Right hip pain after a ground-level trip.

P: Treatments: Spinal motion restriction considered — not applied (isolated hip, reliable, no midline spine pain). Pad/splint in position of comfort; scoop to stretcher. Fentanyl 50 mcg IV at 12:00 — pain 7/10 → 4/10; no respiratory depression. PMS before and after move. Response: Pain decreased after fentanyl. PMS remained intact. No change in mentation. No chest pain.. Ambulance transport and monitoring were required; private vehicle was not appropriate. ALS transport to ED. Aide locked apartment and followed. Report emphasized warfarin and suspected hip fracture.

TRAINING SCENARIO

Call sheet

Fictional source facts. Do not invent times, quotes, or vitals. Never add real PHI.

Engine 2 / Ambulance 6 · dispatched 11:40 · on scene 11:46

An 81 y/o woman tripped on a throw rug at 11:30 and could not get up. She is on warfarin. She denies loss of consciousness, head strike, and chest pain. The right leg is shortened and externally rotated; PMS is intact. You pad and splint in position, consider spinal motion restriction (none applied — isolated hip, no midline spine pain, reliable exam), give fentanyl 50 mcg IV for 7/10 pain with relief to 4/10, and transport to the ED.

Dispatch

81-year-old female on the floor after a fall; hip pain. Caller is home health aide.

Location

Apartment living room, throw rug at hallway junction

Scene

Aide on scene. Patient on the floor, right hip, alert and in pain. Trip on a bunched rug. Furniture not moved. No pets. Well-lit. BLS and engine crew present.

Patient

81 y/o female, estimated 61 kg, English-speaking, GCS 15 / AOx4

Historian

Patient and home health aide (found her)

Chief complaint

Right hip pain after a ground-level trip

Quote

“I tripped on that rug. My right hip is killing me. I did not pass out.”

OPQRST

Onset: Sudden at 11:30 when she tripped
Provocation: Worse with any attempt to move the right hip; better lying still
Quality: Sharp, deep hip and groin pain
Radiation: Right groin and anterior thigh; no back radiation
Severity: 7/10 on scene; 4/10 after fentanyl
Time: Continuous since the fall

SAMPLE

Signs / symptoms: Right hip pain, unable to bear weight, no headache, no chest pain
Allergies: Sulfa (rash)
Medications: Warfarin 4 mg nightly; metoprolol 25 mg; vitamin D
Past history: Atrial fibrillation on anticoagulant; osteoporosis; prior left wrist fracture
Last oral: Breakfast 08:00; last warfarin last night
Events: Walking to kitchen, caught toe on rug, fell onto right side, aide heard the fall and called 911

Exam

AOx4; no scalp hematoma; pupils equal
C-spine nontender, no midline thoracic/lumbar pain
Right leg shortened and externally rotated
PMS intact right foot: pulse 2+, sensation present, wiggles toes
Pelvis stable to gentle compression; abdomen soft
No other obvious deformity

Vitals

Time	BP	HR	RR	SpO₂	GCS	Pain	Skin
11:48	142/78	88 irregular	18	97% RA	15	7/10	warm, dry
12:05	138/76	84 irregular	16	97% RA	15	4/10	—

Timeline

▸11:30 — fall (patient estimate)
▸11:40 — dispatched ground-level fall
▸11:46 — on scene; patient on floor
▸11:48 — exam and first vitals; warfarin noted
▸11:55 — padded in position, scoop/stretcher
▸12:00 — fentanyl 50 mcg IV (ALS)
▸12:05 — pain 7→4; PMS rechecked intact
▸12:08 — departed
▸12:22 — ED; report including anticoagulant

Treatments

Spinal motion restriction considered — not applied (isolated hip, reliable, no midline spine pain)
Pad/splint in position of comfort; scoop to stretcher
Fentanyl 50 mcg IV at 12:00 — pain 7/10 → 4/10; no respiratory depression
PMS before and after move

Response

Pain decreased after fentanyl. PMS remained intact. No change in mentation. No chest pain.

Disposition

ALS transport to ED. Aide locked apartment and followed. Report emphasized warfarin and suspected hip fracture.

Live completeness

0/10

Quote or attributionQuote the patient or historian
Times (HH:MM)Stamp dispatch, interventions, or transport
Vitals with numbersBP, HR, RR, or SpO2
Dose + routee.g. 324 mg PO, 0.4 mg SL
Response / trendWhat changed after treatment
Pertinent negativesName what was denied or absent
Why EMS / transportMedical necessity or capacity/refusal pack
Disposition / handoffDestination, refusal, or bedside report
Key facts 0/3fall, hip, anticoagulant
SOAP structureUse the section labels for this format

Narrative format

Free = preferred format · Pro unlocks all

Subjective · Objective · Assessment · Plan

○ Subjective○ Objective○ Assessment○ Plan

Insert from call sheet

0 chars · 0 words · ⌘/Ctrl+Enter scores

Subjective — Complaint, quotes, OPQRST/SAMPLE

Objective — Exam, vitals, measurements

Assessment — Working impression

Plan — Tx, response, transport, disposition

Need a field paste-out builder? See HandoffNote — NarrativeCoach is academy drills only.