Primary Survey

Primary Survey. The primary survey is the initial assessment and management of a casualty. It is conducted to detect and treat actual or imminent life threats and prevent complications from these injuries.

 

A systematic approach using ABCD is used.

D R S A B C D

D

DANGER

R

RESPONSE

S

SHOUT

A

AIRWAY

B

BREATHING

C

CIRCULATION / CPR

D

DEFIB

DANGER

Remember you are THE most important person on the scene so you need to ensure you are safe before approaching the casualty. If something happens to you then there may not be anyone to help the casualty.

Look at scene as anticipate any dangers such as moving traffic, broken glass, violent offenders, anything that could cause harm to you or further harm to your casualty. 

VIDEO 

Showing approach

RESPONSE

You need to ascertain if the casualty is unconscious or conscious.

This can be done initially by verbal commands such as asking them for their name or if they can hear you, if they respond then they are not unconscious.

 

If no response to verbal command then place your hands on their shoulders and shake them firmly but not violently to see if they respond in anyway through either movement or groaning noises.

 

Ifstill no response then you can pinch their ear lobe to see if a small amount of pain causes any movement or stirring. If not then the casualty is deemed as non responsive (unconscious).

VIDEO 

Showing Response

If your casualty is unconscious you are going to need help, you may not know what you need as yet but get your help there as soon as possible ready for when you do. 

VIDEO 

Showing Shouting for help

SHOUT

AIRWAYS

Some people confuse this with the breathing part of DRSABCD. 

This is simply an airway check, when a person is unconscious al body parts relax and this is especially so with regards to the tongue, this can cause the tongue to relax so much it can fall backwards and block the casualties air way prevent oxygen reaching the lungs, a bit like stepping on a water pipe so no water can get through.

 

Your job in this process is to ensure the tongue is not blocking the airway. This is done simply by using the head tilt - chin lift.

Once done also check inside the throat area for any blockages such as foreign objects, blood, vomit, these need to be cleared. 

VIDEO 

Showing head tilt - chin lift and air way check

BREATHING

No we need to see if the casualty is breathing or not. 

Ensure the head tilt - chin lift is still in place otherwise there is a chance breathing is not taking place due to the tongue blocking the airway. 

Place the side of your cheek to their mouth so you are looking down at their chest area. You must do the following for 10 seconds

  1. Feel their breath on your cheek

  2. Listen for the breath

  3. Look at the chest and abdomen area for signs of breathing movement. 

  4. If no breath is taken within the 10 seconds thn they are not breathing

Don't be fooled by mouth movement alone as these could be agonal gasps. More about agonal gasps

VIDEO 

Showing breathing check

CPR / CIRCULATION

If the casualty is not breathing then you will need to conduct cardio pulmonary resuscitation (CPR) however remember one important thing:

If they have a substantial bleed then this will need treating first otherwise blood will keep pumping from the wound causing catastrophic blood loss. 

The attached video will demonstrate how to conduct effective CPR

VIDEO 

Showing CPR technique

Automated External Defibrillator (AED or DEFIB for short)

See our DEFIB section and our public access defib blog

VIDEO 

Showing CPR technique

DEFIB