Primary Assessment

1. Primary Assessment

2. Primary Assessment

Identifies life threatening conditions
Rapid evaluation in all patients, unconscious or
conscious
Steps should be followed in sequence

3. Primary Assessment Sequence

A – airway and cervical spine control
B – breathing
C – circulation and external bleeding control
D – disability: neurological status
E – expose the chest and abdomen

4. Approaching your patient

Think about safety
•To you and your patient
•Ask yourself
“Is it safe to get close and examine
the patient?”

5. Shake and shout

Think A.V.P.U
(see slide 12)
•Talk to the patient
“Can you hear me?”
•Shake the patient
(gently by the shoulder)

6. A - Open the airway

Head tilt – chin lift
(non – trauma)
Do not put pressure on the neck

7. A - Airway Management and Cervical Spine control

Assessed first to determine if there is a patent
airway
Measures to establish patent airway should be
done while protecting the cervical spine in
trauma patients
Initially, use chin lift or jaw thrust maneuvers in
trauma patients
Inspect for airway obstruction
If the patient can talk then the airways are
normal
Repeat assessment is necessary

8. Jaw thrust

9. Remember!

All patients with multi-system trauma have a cervical
spine injury, until proven otherwise
All patients with an altered level of consciousness have a
cervical spine injury, until proven otherwise
All patients with a blunt injury above the clavicles have a
cervical spine injury, until proven otherwise

10. B – Breathing

Look, listen and feel
Check quality and rate of patient’s breathing
Are they breathing? Is it life supporting?
Expose chest wall and assess chest wall
Injuries to identify in the primary survey –
Tension pneumothorax
Flail chest
Large hemothorax
Open pneumothorax

11. C- Circulation and external bleeding control

Check Pulse - present
rate, strength, regularity
Obvious external bleeding - control
Skin color, temperature
and moisture
Capillary refill

12. D – (Disability): Neurological Status

Assess level of consciousness
A – alert
V – respond to voice
P – respond to pain
U – unresponsive to all stimuli
Pupils of eyes – size, reaction

13. E- Expose

All clothes should be removed
Assess abdomen, pelvis and femurs
Cover patient and keep warm