First aid facts

Primary survey

Introduction
When you either come across a casualty or are called to the scene as a first aider there are certain
procedures that you should follow to make sure you deliver effective, safe and prompt emergency
aid. The first procedure is called the primary survey.
Danger
Before approaching any casualty, you must ensure that there is no danger to yourself. If possible
you should move any potential sources of danger away from the casualty to enable you to carry
out first aid without any risks of further injury to yourself or the casualty. Only as the very last
resort should you move the casualty. Remember the emergency services are trained to do this and
will respond to all emergency calls as quickly as possible.
Response
Check to see if the casualty is conscious.
1 Call their name and shout a command such as Open your eyes or ask questions such as
Can you hear me?
2 Tap them on their shoulders or give them a gentle shake to see if they respond. Do not shake
them hard as you could make their injuries worse.
If there is no response, shout for help and go on to the next stage.

St John Ambulance 2009

First aid facts

Primary survey

Airway
If the airway is blocked the casualty cannot breathe and will die. When a casualty is unconscious
their tongue can easily block their airway. It is, however, very easy to keep an airway open.
Kneel by the casualty and place one hand on their forehead
Tilt their head back gently (do not put your other hand under their neck); their mouth will open
Place your index and middle fingertips under the point of their chin, lift and hold to keep
their airway open.

Breathing
Once you have opened the airway, you must check to see whether the casualty is
breathing normally.
Place your cheek just above the casualtys mouth and nose
Look, listen and feel for breathing for no more than 10 seconds. Look at their chest for
movement, listen for sounds of breathing and feel for breath on your cheek.
In the first few minutes after a heart has stopped it is common to see agonal breathing. This is
short, infrequent gasps for breath. If the casualty is not breathing or they have agonal breathing,
start resuscitation immediately.

Circulation
If the casualty is breathing look and feel for severe blood loss.
A good way to remember this primary survey sequence is DRABC.
Danger
Response
Airway
Breathing
Circulation.

St John Ambulance 2009

First aid facts

Primary survey

Primary survey flowchart

Assess the situation
Are there any risks to you or
the casualty?

Yes
Deal with any dangers to make
the situation safe.

No
Assess the casualty
Is the casualty conscious?
Does the casualty respond?

Yes
Check for life threatening injuries; treat the
casualty and dial 999 or 112 for an
ambulance, if necessary.

No
Shout for help
Open the airway.
Is the casualty breathing?

No

Yes
Control any severe bleeding and place the
casualty in the recovery position and
dial 999 or 112 for an ambulance.

Dial 999 or 112 for an ambulance

Send a bystander if possible.

Begin chest compressions

Give the casualty 30 chest compressions.

Note: If the casualty is a child

or has drowned, refer to the
current edition of the First Aid Manual.

Begin rescue breaths

Give the casualty two rescue breaths.

Continue CPR
Continue until emergency help arrives,
the casualty begins to breathe for
themselves or you are too tired to continue

St John Ambulance 2009