The primary survey ( St Johns Ambulance)
This is a quick way for you to find out if the casualty has any injuries or conditions which are life-threatening.
Follow the steps methodically to identify each life-threatening condition and deal with them in order of priority.
Use the letters DR ABC to remember the steps:
You’ll need to go through the primary survey every time you help someone, and make sure you don’t get distracted by anything else.
Only move onto the secondary survey if you’ve completed the primary survey and succeeded in dealing with any life-threatening conditions.
If someone needs help, before you go up to them check – is it safe?
No – if you can see or hear any danger nearby, for you or the casualty, like broken glass or oncoming traffic, then make the situation safe before you get any closer.
Yes – if you can’t see or hear any danger then it is safe to go up to them.
Does the casualty respond when you ask them: ‘Are you alright?’ or if you say: ‘Open your eyes!’
No – if the casualty doesn't respond, then gently shake their shoulders, or with a child – tap their shoulder, and with a baby – tap their foot. If they still don’t respond, then you can presume they’re unconscious and move on to the next stage: Airway.
Someone who’s unconscious always takes priority: treat them first and as quickly as possible.
Yes – if the casualty responds by making eye contact with you or some gesture then you know that they’re conscious and you can move on to the next stage: Airway.
Is their airway open and clear?
No, their airway isn't clear – but they're conscious
If the casualty is conscious, treat them for conditions that may be blocking their airway, such as choking. Only move on to the next stage – Breathing – once their airway is open and clear.
No, their airway isn't clear – and they're unconscious
If they’re unconscious, tilt their head and lift their chin to open their airway. Only move on to the next stage – Breathing – once their airway is open and clear.
Yes –if their airway is open and clear, move on to the next stage: Breathing.
Are they breathing normally? You need to look, listen and feel to check they’re breathing.
No, they're not breathing – but they're conscious
If they’re conscious, treat them for whatever is stopping them breathing – for example, an obstructed airway . Then go to the next stage: Circulation.
No, they're not breathing – and they're unconscious
If they’re unconscious and not breathing, get someone to call 999 or 112 for medical help, and start giving chest compressions and rescue breaths (CPR – cardiopulmonary resuscitation). If this happens you probably won’t move on to the next stage as the casualty needs resuscitation.
Yes – if they are breathing normally, move on to the next stage: Circulation.
Are there any signs of severe bleeding?
Yes – control the bleeding with your gloved fingers, dressing or clothing, call 999 or 112 for an ambulance and treat the casualty to reduce the risk of them going into shock
No – if they aren’t bleeding, and you’re sure you have dealt with any life-threatening conditions, then move on to the secondary survey, to check for any other injuries or illnesses.
Unconscious and not breathing adult
If they’re unconscious and not breathing, you’ll need to do CPR (which is short for cardiopulmonary resuscitation). CPR involves giving someone a combination of chest compressions and rescue breaths to keep their heart and circulation going to try to save their life. If they start breathing normally again, stop CPR and put them in the recovery position
• To check if someone is unconscious and not breathing, you need to assess the casualty by doing the Primary Survey.
• If you find they’re unconscious and not breathing then you’ll need to call 999/112 for emergency medical help.
Step 1 of 5: Open their airway
Place one hand on the casualty’s forehead and gently tilt their head back. As you do this, the mouth will fall open slightly.
Step 2 of 5: Check their breathing
- Look for chest movement, listening for the sounds of normal breathing and seeing if you can feel their breaths on your cheek.
If they are not breathing, you need to start CPR (cardiopulmonary resuscitation – a combination of chest pressure and rescue breaths) straight away.
Step 3 of 5: Call for help and start CPR
Call 999 or 112 for an ambulance, or get someone else to do it.
Next you’ll need to perform CPR - cardiopulmonary resuscitation. This involves giving someone chest compressions and rescue breaths to keep their heart and circulation going.
If they start breathing normally again, stop CPR and put them in the recovery position.
Step 4 of 5: Giving chest compressions
• Kneel down beside the casualty on the floor level with their chest.
• Place the heel of one hand towards the end of their breastbone, in the centre of their chest.
• Place the heel of your other hand on top of the first hand and interlock your fingers, making sure you keep the fingers off the ribs.
• Lean over the casualty, with your arms straight, pressing down vertically on the breastbone, and press the chest down by 5-6cm (2-2½in).
• Release the pressure without removing your hands from their chest. Allow the chest to come back up fully – this is one compression.
Repeat 30 times, at a rate of about twice a second or the speed of the song ‘Staying Alive’.
Give two rescue breaths.
Step 5 of 5: How to give a rescue breath
• Ensure the casualty’s airway is open.
• Pinch their nose firmly closed.
• Take a deep breath and seal your lips around their mouth.
• Blow into the mouth until the chest rises.
• Remove your mouth and allow the chest to fall.
Repeat once more.
Carry on giving 30 chest compressions followed by two rescue breaths for as long as you can, or until help arrives.
If the casualty starts breathing normally again, stop CPR and put them in the recovery position.
Red Cross CPR Video: