Primary and Secondary Survey

Figure 1: How to check a radial pulse.

After you have checked the airway, work of breathing, and circulation, think about the person’s

mental status. Do they make sense or are they asking the same questions over and over again?

Do they follow simple commands? Is there drooping of one side of the face, an inability to talk,

or weakness on one side or the other of the body? These are all signs of an abnormal mental

status or possibly a stroke. An individual doesn’t have to be unconscious to have brain

problems. A low level of consciousness or confusion is a sign that you probably need to call an

ambulance.

PRIMARY AND SECONDARY SURVEY

EMTs and paramedics do a primary and secondary survey when encountering a sick or injured

person for the first time. This is basically what you should do when deciding if a person is in an

emergency situation and is sick or injured.

We’ve already covered the primary survey, which involves the heart function, the work of

breathing, the airway or breathing tube function, and the level of consciousness. These are

considered the most life-threatening issues you must deal with. A problem with any of these

things means you should call an ambulance as soon as you can. The person needs more care

than you can give them with first aid measures.

The other thing that should be done in the primary survey is to assess for dangerous situations.

For example, if there is toxic gas get out of the area, taking the injured person with you only if it

is safe for you to do so. If there is a fire, get out and ask questions later. Once safe, get an idea

of what happened to the individual from other bystanders or from the victim themselves.

If the primary survey indicates a problem, you may have to intervene to save the person’s life

before the paramedics arrive. We’ll talk about what you can do to help the victim in later

chapters. If the person has no problems in the primary survey, you can do a secondary survey.

While awaiting help or deciding if the person really needs help, you need to ask questions and

look the person over more carefully. Questions you should ask, whether this is a trauma victim

or a sick person, include:

A. What happened leading up to the person’s symptoms?

B. What symptoms does the person have?

C. Is the person allergic to anything?

D. Does the person take any particular medications?

E. What health problems has the person had?

F. When did the person last eat anything?

While you are asking these questions, take a few minutes to check the person from head to toe,

looking for bleeding, broken bones, open sores, or areas of soreness. If the person has a

specific complaint, you can focus on that as part of the secondary survey. Look for bruising or

deformities of the chest, abdomen, or extremities.