Primary Assessment steps

Primary assessment (1)

General Impression: ask
a. Trauma: delegate manual c-spine precaution with permission PRN
b. Major bleed: delegate bandage/tourniquet with permission PRN

Primary assessment (2)

LOC/Permission: AVPU & Consent
a. Alert: perform ABC with expressed/informed consent
i. Introduce yourself and obtain patient name
ii. Obtain chief complaint
iii. If patient refuses assessment, immediately determine orientation
b. Not alert: perform CAB with implied consent
i. Ask bystanders if anyone knows patient name/age

Primary assessment (3)

Airway: assess to determine patent vs. compromised
a. Visualize patient’s tongue and oropharynx using penlight PRN
b. Patent if self-maintained and able to swallow with no visible obstruction
c. Compromised if unresponsive or altered
i. Open with jaw thrust or head-tilt, chin lift
ii. Consider adjunct: OPA/NPA
iii. Consider suction

Primary assessment (4)

Breathing: assess using hands on and/or auscultation PRN
a. Adequate rate/volume/quality: consider NC/NRB/CPAP
b. Inadequate rate/volume/quality: consider BVM

Primary assessment (5)

Circulation: assess with hands on
a. Pulse: assess rate/rhythm/quality
i. Radial if conscious adult
ii. Carotid if unconscious adult
b. Skin perfusion: assess color/temperature/condition (moisture)

Primary assessment (6)

Deformity/Disability/Disorientation: assess
a. Deformity: life-threatening?
b. Disability: language/communication barrier?
c. Disorientation: confusion?

Primary assessment (7)

Expose: life/remove/cut clothes PRN

Primary assessment (8)

Patient Treatments, Patient Category, and Delegation:
a. Find it → fix it: confirm treatment of ABCs before moving on
b. MEDIC: Minimal/Expectant/Delayed/Immediate/Contaminated
c. Delegate roles to crew: do not actually move patient yet