by Kaitlyn Edwards

Created on: September 15, 2010   Last Updated: November 30, 2011

The primary survey is used to quickly check a casualty over for life threatening conditions.

It starts when discovering the casualty with checking for danger. It is important that ou check for danger to yourself and the casualty. Danger may be obvious (a fire, a collapsing building) or less obvious (a gas leak).

Next is checking the response. Whether or not the casualty has a response is important, but this can be further classified into the level of response. There are two methods to this. The first is the Glasgow Coma Scale (GCS). This is a 15 point scale, with the lowest value being three (completely unresponsive) to the highest value of 15 (alert and orientated). This system should only be used by those trained to do so. The second, simpler method is known as AVPU. Is the casualty (A) alert? Are they responsive to (V) voice - do they open their eyes when asked to, for example? Is the casualty responsive to (P) pain. For this, you do not inflict physical pain on your casualty. Does the casualty respond to physical stimuli, a shake of the shoulder, for instance? Or is the casualty (U) unresponsive? You can use this system to track a fluctuating conscious level.

Next call for help. Shout loudly.

Check the airway. Is it clear or is it blocked by food, dentures etc? If able to do so, remove a blockage by tilting the head and allowing it to fall out. Do not go poking your finger in the back of the casualty's throat as this may further block the airway, or, if you scratch the back of the throat, it may swell and cause an obstruction. Open the airway by placing one hand on the forehead and two fingers under the chin. Tip the head backwards and lift the chin upwards. If you suspect a spinal injury, and are trained to do so, preform a jaw thrust.

Next check for breathing for up to 10 seconds. Is the casualty breathing or not? That is the main concern for the first aid. Further considerations may include the rate and depth of breaths, whether the both sides of the chest are rising and falling, the use of accessory muscles (the shoulders and abdomen) and what the breathing sounds like. It is also important to look for agonal breathing, which is irregular, ocassional gasps. This is not breathing, and the casualty should be treated as though they are not breathing, as this suggests that the casualty is about to stop breating. If you witness this type of breathing, you will never forget it. The person can stop breathing for a very long time before taking another gasp.

If breathing is absent, phone an ambulance and commence CPR.

If breathing is present, continue on to the secondary survey. Those trained to do so may wish to check circulation for regularity, rate and strength.

Remember, the aim of the primary survey is to prioritse life threatening conditions. A person is going to die quicker through being unable to breathe than through bleeding, burns etc.

Also remember to protect yourself from cross infection and wear gloves. You do not know when you may come in to contact with bodily fluid or exposed mucus membranes - these are both potential ways of transmitting infection.

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