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

hypoglycemia · medium

Hypoglycemia with Improvement

Fictional diabetic with low glucose and response to treatment.

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 99 (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: 47 y/o female, estimated 70 kg, English-speaking, initially GCS 13 (confused) then GCS 15. Historian: Spouse (last meal, insulin) and patient after treatment. Patient/historian stated "After glucose: I skipped breakfast. I took my insulin anyway." Chief complaint: Confusion and diaphoresis in a known diabetic. Signs/symptoms: Diaphoresis, confusion, shakiness, no chest pain, no seizure. Allergies: no known drug allergies. Medications: Insulin glargine 18 units QHS; insulin lispro with meals (took 6 units this morning). Past medical history: Type 1 diabetes; no known CAD. Last oral: Dinner ~19:00 last night; skipped breakfast. Events: Woke 06:45, took lispro, felt 'off,' spouse found her confused at 07:00. Pertinent negatives: no seizure; denied chest pain. This TRAINING SCENARIO includes glucose, diabetes, oral glucose. Care included oral glucose, recheck glucose.

O: Location: Bedroom / edge of bed, private residence. Scene: Morning. Spouse in a robe. Patient sitting on the edge of the bed, diaphoretic, slow to answer. Glucometer on the nightstand with a strip reading LO. Insulin pens in a kitchen drawer. No needles on the floor.. Exam: Initially AOx1 (name only), slow speech, follows simple commands; Skin pale, cool, diaphoretic; No focal weakness; no tongue trauma; no incontinence; Lungs clear; no insulin pump on body. Serial vitals: 07:12 BP 128/76 HR 96 RR 16 SpO2 98% RA; GCS 13, glucose 48, skin pale, diaphoretic. 07:24 BP 124/74 HR 84 RR 16 SpO2 98% RA; GCS 15, glucose 96, skin warm, less moist.

A: Working impression for this TRAINING SCENARIO: Hypoglycemia with Improvement — Confusion and diaphoresis in a known diabetic.

P: Treatments: Oral glucose 15 g at 07:14 (able to swallow, intact airway). Recheck glucose 96 at 07:24. Oxygen not required. No IV; ALS available if she declined oral. Response: Mentation improved to AOx4. Glucose 48 → 96. Diaphoresis decreased. Denied chest pain throughout. No seizure.. Ambulance transport and monitoring were required; private vehicle was not appropriate. BLS/ALS transport to ED for evaluation. Spouse rode in front. Patient initially considered refusing after improvement; agreed after discussion of recurrence risk (this scenario outcome is transport).

TRAINING SCENARIO

Call sheet

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

Ambulance 9 · dispatched 07:05 · on scene 07:11

A 47 y/o woman with type 1 diabetes is found confused and sweaty after taking morning insulin and skipping breakfast. Fingerstick glucose is 48. She has not seized and denies chest pain. You give oral glucose gel; she swallows. Recheck is 96 and mentation clears. She agrees to ED evaluation for dose/meal mismatch.

Dispatch

Known diabetic, confused, sweaty. Caller is spouse.

Location

Bedroom / edge of bed, private residence

Scene

Morning. Spouse in a robe. Patient sitting on the edge of the bed, diaphoretic, slow to answer. Glucometer on the nightstand with a strip reading LO. Insulin pens in a kitchen drawer. No needles on the floor.

Patient

47 y/o female, estimated 70 kg, English-speaking, initially GCS 13 (confused) then GCS 15

Historian

Spouse (last meal, insulin) and patient after treatment

Chief complaint

Confusion and diaphoresis in a known diabetic

Quote

“After glucose: I skipped breakfast. I took my insulin anyway.”

SAMPLE

Signs / symptoms: Diaphoresis, confusion, shakiness, no chest pain, no seizure
Allergies: NKDA
Medications: Insulin glargine 18 units QHS; insulin lispro with meals (took 6 units this morning)
Past history: Type 1 diabetes; no known CAD
Last oral: Dinner ~19:00 last night; skipped breakfast
Events: Woke 06:45, took lispro, felt 'off,' spouse found her confused at 07:00

Exam

Initially AOx1 (name only), slow speech, follows simple commands
Skin pale, cool, diaphoretic
No focal weakness; no tongue trauma; no incontinence
Lungs clear; no insulin pump on body

Vitals

Time	BP	HR	RR	SpO₂	GCS	Glucose	Skin
07:12	128/76	96	16	98% RA	13	48	pale, diaphoretic
07:24	124/74	84	16	98% RA	15	96	warm, less moist

Timeline

▸07:05 — dispatched diabetic emergency
▸07:11 — on scene
▸07:12 — glucose 48; first vitals
▸07:14 — oral glucose gel 15 g; patient swallowed
▸07:24 — recheck glucose 96; mentation improved
▸07:28 — departed
▸07:40 — ED; report of insulin/meal mismatch

Treatments

Oral glucose 15 g at 07:14 (able to swallow, intact airway)
Recheck glucose 96 at 07:24
Oxygen not required
No IV; ALS available if she declined oral

Response

Mentation improved to AOx4. Glucose 48 → 96. Diaphoresis decreased. Denied chest pain throughout. No seizure.

Disposition

BLS/ALS transport to ED for evaluation. Spouse rode in front. Patient initially considered refusing after improvement; agreed after discussion of recurrence risk (this scenario outcome is transport).

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 0/3glucose, diabetes, oral glucose
SOAP structureUse the section labels for this format

Narrative format

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.