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

syncope · medium

Witnessed Syncope

Fictional syncope with bystander history. Include pertinent negatives.

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 96 (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: 64 y/o male, estimated 80 kg, English-speaking, GCS 15 / AOx3 after a brief confused interval. Historian: Bystander (witnessed event) and patient (after waking). Patient/historian stated "I stood up and the next thing I knew this person was holding me." Chief complaint: Witnessed syncope with residual dizziness. Signs/symptoms: Brief loss of consciousness, residual lightheadedness, no current chest pain, no headache. Allergies: Penicillin (rash). Medications: Amlodipine 5 mg daily; tamsulosin 0.4 mg nightly. Past medical history: Hypertension; BPH; no known seizure disorder or diabetes. Last oral: Sandwich and coffee about 12:00. Events: Waited ~20 minutes seated; stood when bus appeared; slumped; bystander lowered him to the bench. Pertinent negatives: no seizure activity; no incontinence; no head trauma. This TRAINING SCENARIO includes syncope, bystander, glucose. Care included glucose check, monitor.

O: Location: City bus stop bench, sidewalk, daylight, dry pavement. Scene: Crowd dispersing. One bystander kneeling beside a man sitting on the bench. No traffic hazard after engine blocks the curb lane. No blood on pavement. Patient awake, embarrassed, wants to go home.. Exam: Now sitting, AOx3 (person, place, time); No scalp laceration, no Battle sign, no step-off; Tongue not bitten; clothes dry (no incontinence); Lungs clear; abdomen soft; No focal weakness; gait not tested on scene (dizzy). Serial vitals: 14:09 BP 102/64 HR 52 RR 16 SpO2 97% RA; GCS 15, glucose 92, skin pale, warm, dry. 14:22 BP 118/72 HR 64 RR 16 SpO2 98% 2 L NC; GCS 15, glucose 92.

A: Working impression for this TRAINING SCENARIO: Witnessed Syncope — Witnessed syncope with residual dizziness.

P: Treatments: Supine then semi-Fowler on stretcher. Glucose check 92 mg/dL at 14:09. Oxygen 2 L NC. Cardiac monitor; 12-lead en route (training: sinus bradycardia ~52 then 64). Spinal motion restriction not applied — no trauma mechanism, no midline tenderness. Response: Remained AOx3 after the first minute. Dizziness improved when supine. No recurrent syncope.. Ambulance transport and monitoring were required; private vehicle was not appropriate. ALS monitor transport to ED. Patient initially wanted to go home; after risks of syncope NYD explained he agreed to transport. Bystander declined to follow.

TRAINING SCENARIO

Call sheet

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

Ambulance 3 · dispatched 14:02 · on scene 14:07

A 64 y/o man stood from a bus-stop bench, lost consciousness for about 30 seconds, and was caught by a bystander as he slumped. No seizure-like activity, no incontinence, no head strike. He woke confused for under a minute and is now dizzy but AOx3. Glucose is 92. He denies chest pain and palpitations now. You give oxygen as needed, monitor, and transport to the ED despite his preference to go home.

Dispatch

Adult male passed out at a bus stop; now awake. Bystander caller.

Location

City bus stop bench, sidewalk, daylight, dry pavement

Scene

Crowd dispersing. One bystander kneeling beside a man sitting on the bench. No traffic hazard after engine blocks the curb lane. No blood on pavement. Patient awake, embarrassed, wants to go home.

Patient

64 y/o male, estimated 80 kg, English-speaking, GCS 15 / AOx3 after a brief confused interval

Historian

Bystander (witnessed event) and patient (after waking)

Chief complaint

Witnessed syncope with residual dizziness

Quote

“I stood up and the next thing I knew this person was holding me.”

SAMPLE

Signs / symptoms: Brief LOC, residual lightheadedness, no current chest pain, no headache
Allergies: Penicillin (rash)
Medications: Amlodipine 5 mg daily; tamsulosin 0.4 mg nightly
Past history: Hypertension; BPH; no known seizure disorder or diabetes
Last oral: Sandwich and coffee about 12:00
Events: Waited ~20 minutes seated; stood when bus appeared; slumped; bystander lowered him to the bench

Exam

Now sitting, AOx3 (person, place, time)
No scalp laceration, no Battle sign, no step-off
Tongue not bitten; clothes dry (no incontinence)
Lungs clear; abdomen soft
No focal weakness; gait not tested on scene (dizzy)

Vitals

Time	BP	HR	RR	SpO₂	GCS	Glucose	Skin
14:09	102/64	52	16	97% RA	15	92	pale, warm, dry
14:22	118/72	64	16	98% 2 L NC	15	92	—

Timeline

▸13:58 — bystander estimates LOC began
▸14:02 — dispatched syncope
▸14:07 — on scene; patient sitting on bench
▸14:09 — first vitals; glucose 92
▸14:11 — oxygen 2 L NC for pallor (SpO2 97%)
▸14:18 — moved to stretcher, monitored
▸14:22 — en route vitals
▸14:34 — ED arrival; bystander statement relayed

Treatments

Supine then semi-Fowler on stretcher
Glucose check 92 mg/dL at 14:09
Oxygen 2 L NC
Cardiac monitor; 12-lead en route (training: sinus bradycardia ~52 then 64)
Spinal motion restriction not applied — no trauma mechanism, no midline tenderness

Response

Remained AOx3 after the first minute. Dizziness improved when supine. No recurrent syncope.

Disposition

ALS monitor transport to ED. Patient initially wanted to go home; after risks of syncope NYD explained he agreed to transport. Bystander declined to follow.

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 0/3syncope, bystander, glucose
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.