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The information contained in this document has been compiled from sources believed to be reliable at the time and is presented here as a study aid and for general information use only. This information is not intended to replace or supercede the information or procedures outlined in your first aid textbook, other officially issued study materials or government published acts or legislative documents.
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Primary Survey:
Is how you find out if the casualty has any life threatening conditions and you give life-saving first aid. It focuses on the ABC’s (AIRWAY, BREATHING and CIRCULATION). If the casualty is conscious and talking, you know they have an open airway and are breathing. If a neck or spinal injury is suspected you must open the airway using the modified jaw thrust method in order to reduce movement of the head and neck, and further injury.

The Primary survey beings from where the scene survey ends.
1.
Check the airway. Ask a question and see how well the casualty can answer. The airway may not be open if casualty is unresponsive. If there is no suspected head or neck injury, use the head-tilt chin-lift to open the airway. You do this by:
• Placing one hand on the forehead
• Two fingers under the bony part of the jaw
• Gently tilt back on the forehead and lift the jaw at the same time.
2.
Check for breathing. Keep the airway open and check for breathing for up to 10 seconds. You do this by:
• Keep the head tilted
• With your ear not more than 3 inches from the casualty’s mouth and nose, check for breathing
• Look for chest movement
• Listen for sounds of breathing and
• Feel for breath on your cheek

If the person is not breathing give casualty two slow breaths and check for signs of circulation for no more than 10 seconds. Signs of circulation include movement or coughing in response to the two breaths and a carotid pulse. If there are signs of circulation BUT NO BREATHING, give artificial respiration (mouth-to-mouth). If there are no signs of circulation or if you are not sure, give CPR (mouth-to-mouth with chest compressions).
If there is breathing but it is ineffective, give first aid that will help breathing and send for medical help. Assist the casualty’s breathing if they consent. If breathing is effective follow the next step.
3.
Check circulation. Checking circulation refers to seeing if the heart is pumping blood to vital organs. You do this by observing the casualty and seeing if he or she is breathing, is coughing, if there is any kind of movement of the casualty and by checking the carotid pulse for not more than 10 seconds. The carotid pulse is taken by placing two fingers on the carotid artery found on either side of the casualty’s neck just parallel to the windpipe (trachea).

If none of the signs listed are present there is no circulation, and CPR must be started immediately in order to preserve the casualty’s life.
4.
Other things to check. If there is any obvious, severe bleeding, give first aid to control it. Bleeding is severe when blood spurts or flows freely from a wound. Second, check for shock by assessing skin condition and temperature. If there are signs of shock, send for medical help right away.
• Feel the skin temperature using the back of your hand to the casualty’s forehead, cheek or neck (pull back glove if you need to if you are wearing one)
• Check skin colour for paleness or blueness
• Look for sweating or goosebumps
If you suspect other injuries, do a rapid body survey to check for any other bleeding or signs of severe internal bleeding. You do this by quickly running the flats of your hands over the body looking for blood that is hidden from view and for obvious deformity that may indicate serious injury. Expose painful areas to look for signs of internal bleeding. The rapid body survey should take 30 seconds or less.

• Check head and neck
• Look at the face for signs of pain
• Check the shoulders, arms and hands, the chest and under the abdomen and under the pelvis and buttocks, the legs and feet.
If blood is found, expose the wound and control the bleeding if it is severe. Send for medical help. Support an obviously deformed limb with your hands.

Do a secondary survey if:
• The casualty has more than one injury
• Medical help will be delayed more than 20 minutes
• Medical help is not coming to the scene and you have to transport the casualty (transporting a critically ill casualty should be considered the last resort in an urban center.)
• If you don’t do a secondary survey, steady and support any injuries and give ongoing casualty care.
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