When you find a casualty it is important to perform a primary survey- this is a rapid assessment to safely assess whether someone has life-threatening injuries.
The order of the primary survey is intentional; it allows you to consider each body system in order of priority, assessing first those injuries that will cause fatality the quickest i.e. Airway and Breathing. The contents and order of the primary survey can be easily remembered by using the mnemonic DR.ABC:
Ensure safety for yourself and any others. Do not put yourself at risk.
- Remove danger if safe to do so
- Find out what has happened from witnesses if possible. Get information.
Is the casualty responsive (conscious)?
Gently shake each shoulder and ask loudly: “Can you hear me? Open your eyes.”
- Assess the patient’s level of consciousness using the AVPU score (see levels of response AVPU).
Make sure the casualties airway is a clear.
- Loosen any tight clothing around the neck area.
- Carefully open the airway by gently tilting the head back with one hand on the casualty’s forehead and Lift the chin by placing 2 fingers under the point of the chin
Keeping the casualties head and chin tilted
LOOK, LISTEN and FEEL for normal breathing for up to 10 seconds
NOTE: In the first few minutes after cardiac arrest, you may hear infrequent, noisy gasps. These are known as “agonal” gasps and are NOT the same as normal breathing.
- If in doubt, start CPR
- If the casualty is unresponsive and breathing normally, place them in the recovery position
- IMPORTANT: If the casualty is not breathing, you must call or ask someone to call 999 or 112 for emergency help and start CPR immediately
Identify and treat any life threatening circulation problems such as severe bleeding or heart attack
- Attach an AED (Automatic External Defibrillator) as soon as it arrives, if available at your workplace. Follow voice prompts.