Primary Survey

What is the primary survey?

The primary survey is a quick way to find out how to treat any life threatening conditions a casualty may have in the correct order of priority.  We can use DRABC to do this: Danger, Response, Airway, Breathing and Circulation. (More commonly known as Doctor ABC)

1. Danger. Before approaching the casualty, always make sure the area is safe, e.g. Isolate the power, stop traffic, switch off machinery.

2. Response. Check if the casualty is responsive or unresponsive. As you approach them, introduce yourself and ask them questions to see if you can get a response. Kneel next to their chest and gently shake their shoulders, asking, ‘What has happened?’, ‘Open your eyes!’. Always ask permission to assist before touching any casualty.

If the casualty opens their eyes, or gives another gesture, they are responsive.

If they do not respond to you in any way they are unresponsive and should be treated as quickly as possible and shout for help if no one is with you!

3. Airway. Next, you need to check that the airway is open and clear. Open the airway by placing one hand on the forehead to tilt the head back and use two fingers from the other hand to lift the chin.

If they are unresponsive, you need to move on to breathing as quickly as possible.

4. Breathing. You now need to check if the casualty is breathing normally. Place your ear above their mouth, looking down their body. Listen for sounds of breathing and see if you can feel their breath on your cheek. Watch to see if their chest moves. Do this for 10 seconds.

If they are unresponsive and not breathing, you need to call 999/112 for emergency help and start CPR straight away. Ask a helper to find and bring a defibrillator (AED).

If they are responsive and breathing move on to circulation.

5. Circulation. Once you have established they are breathing, look and check for any signs of severe bleeding.

If they are bleeding severely you will need to control and treat the bleeding by applying direct pressure to the wound. Call 999/112 for emergency help.

If they are unresponsive and breathing but with no bleeding, put them in the recovery position and call 999/112 for emergency help.

Ensure you perform the Primary survey first on every casualty and until it’s complete, do not be distracted by more superficial, non life threatening conditions.

In a multi casualty situations, you must prioritise the treatment to the casualties dealing with the casualties with the most life threatening conditions first (ABC). 

6. Once you have completed your primary survey and have treated any life-threatening conditions you can move on to the secondary survey (top to toe survey).

Next check the casualty from head to toe. Protect their dignity and ask permission if possible. Wear disposable gloves and don't move more than necessary.

SAMPLE

SAMPLE can be used to remember some important things to ask the casualty:

S - Signs and Symptoms: How do they look and feel?

A - Allergies: Do they have any?

M - Medication: Are they on any?

P - Past Medical History: Do they have any?

L - Last Meal: When and what?

E - Event History: What happened and when?