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September 12, 2023

What Happens During a Primary Assessment?

When first aiders are faced with a trauma situation, they must perform an initial assessment of the patient to determine the severity of their injury and take necessary action. A primary assessment (or primary survey, or DRSABC) is the most important step in any patient's first aid treatment.

During the primary assessment, a patient’s mental status, airway, breathing and circulation must be checked in order of priority. Any life threat that is detected must be fixed immediately before proceeding with the next step. Most first-year EMT and paramedic students will shout out, in almost perfect unison, “Anything that threatens the patient’s respiratory or cardiovascular status!” This is a great general rule to remember, but medicine is never quite so simple.

The primary survey is a set of five steps, which are commonly remembered using the acronym DRSABC. These steps must be performed in the correct sequence, as each one is vitally important to a patient’s survival.

Step 1: Look around the casualty for danger to you or anyone else. Check that it is safe to approach them and that they are not in a position that could worsen their injury, for example lying face up on the ground.

Step 2: Check that their airway is clear. This is done by placing your hand on their forehead and tilting their head back, lifting the chin. You can also check that their neck is not a risk for further injury by gently shaking them. You can also try saying ‘ah’ in their ear and shining your pen light on their mouth to see if they have an obvious blockage that could cause them to choke.