What Is the Purpose of a Primary Survey?

The primary survey is the first step in immediately identifying and treating any life-threatening conditions. A precise series of observations allows medical personnel to appraise patients while caring for them, preventing further complications. Emergency medical technicians and hospital staff most commonly use the primary survey, but people without medical training can use a less-thorough version of the program to help patients.

Function

• Caretakers first examine a patient's airways to determine if he is breathing before moving on to check for injuries, bleeding, bruising and other physical trauma. They next check the pulse rate and search for signs of internal bleeding or other injuries marked by swelling, tenderness, or rigidity. After determining the patient's level of consciousness, medical personnel conduct a more thorough investigation, searching for hidden or less-obvious injuries. At each level, caretakers render necessary treatments.

Features

• Various acronyms serve as mnemonic devices to ensure that caretakers provide a thorough head-to-toe examination. The best-known acronym is ABC, for checking the airway, checking breathing and bruises and assessing the pulse or circulation. Added to this are DEF, or seeing if the patient is disabled, followed by exposing and evaluating the patient, and then conducting a full examination. Other acronyms include AVPU, a reminder to determine the patient's level of consciousness, and DCAP-BTLS, for completing a physical inspection.

Considerations

• While the physical examination is extremely important, caretakers should gather as much additional information as possible. Ask conscious patients about complaints, pains, and other symptoms, as well as medical background, medicines taken and allergies. Search for medical alert bracelets or necklaces, nearby prescription bottles or other clues. If the patient is unconscious or unresponsive, question family members or witnesses.

Benefits

• The foremost advantage to this approach is that it treats wounds and other problems quickly, potentially preventing further damage. One of the first steps in the primary survey is to make sure the area is safe so that both patient and caretaker are not at risk for injury. Non-medical personnel can use the primary survey to update medical professionals as they arrive.

Misconceptions

• Although the primary survey is meant to diagnose and treat as many problems in as short a time as possible, shortcuts can be taken, first by immobilizing the patient and then examining using steps ABCD only. Primary survey is not the last step before full diagnosis, but a precursor to the secondary survey, followed by a complete medical examination.