First Aid Fundamentals

What is the Primary Survey in First Aid?

first aid training scenario
Learners being put through their paces on a bespoke course for a dive centre. Here, the team are working together, treating a casualty after effectively identifying the issues using the Primary Survey.

You may have heard of the term ‘Primary Survey’ – but what is it? Simply put, we complete a Primary Survey to find all life threatening issues a casualty may have in order of priority. If we can find issues in order of priority, we can treat them in order of priority – which makes sense!

Remembering to check things in order requires a system. This ensures everything is checked in the correct order and that nothing is missed.

“If you can’t find it — you can’t fix it!”

We can only treat things we find – so we have to be good at working out what the issues are!

What does DR ABC stand for in First Aid?

Remembering DR ABC helps us find the most important issues first. This stops us from being distracted by less important issues. An unresponsive casualty with an obviously broken arm might look bad, but their blocked airway which may not be as obvious is a greater priority.

The system follows a logical sequence – which really helps in times of stress.

Although various systems exist in First Aid, the most common, basic, system people follow is DR ABC.

D – Danger

R – Response

A – Airway

B – Breathing

C – Circulation

Sometimes, an additional <C> is added after the DR – which stands for ‘catastrophic bleeding’. We can also add D and E.

D – Damage or Disability

E – Environment

Why follow DR ABC and not another system?

Most professional services such as Ambulance Services, Fire Services, the RNLI, Mountain Rescue etc., start with DR ABC. It also means that when we need to work alongside professional services or handover to them, we’re all ‘speaking the same language’!

At Life Saving Training, we generally teach DR<C>ABCDE, especially on our Outdoor First Aid and First Aid at Work courses as we want people to be the best First Aiders they can be – but we’ll focus on DR ABC here to keep things simple!

Why is DR ABC Important?

As we’ve already mentioned, DR ABC helps us to find serious issues a casualty has. Many course providers quickly whip through DR ABC and then move on. At Life Saving Training we spend probably longer than average developing the foundations and really embedding the DR ABC algorithm. 

We strongly believe that if you can’t find find a problem – you can’t fix it. So, we need to get good at finding issues, in order, using the system!

Once we can find issues – then we spend time learning how to treat the different issues we may find.

Why embed DR ABC?

At Life Saving Training we spend time embedding DR ABC because, if you remember DR ABC, it makes your life really easy! 

As we’ve already said, not only does DR ABC help you find issues, it helps you to prioritise treating them.

All First Aid issues fit into either D-R-<C>-A-B-C-D or E, which allows you to prioritise treatment – no matter how many issues they have.

Why is that important? In the real world, casualties may have more than one issue – so we need to be able to prioritise finding and treating those that are most serious. For example, a casualty who has been hit by a vehicle or has fallen from a ladder may have a suspected spinal injury, but they may also have airway problems, breathing problems, be bleeding and have broken bones. Embedding DR ABC takes the pressure off in an emergency and tells us what to check and treat first – no matter what the situation is.

How else is DR ABC used in First Aid?

Once we’ve laid the foundations and got good at the Primary Survey, every skill and concept trained during our courses is clearly identified in terms of where it fits into the framework / algorithm. For example, during medical conditions, learners recognise for themselves that Asthma is an A (Airway) problem and therefore is a very high priority. A heart attack would be C, a circulation issue.

Knowing how to find and treat issues in order of priority takes a lot of pressure off a First Aider or First Responder. People on our courses love that we really take the time to get the basics right, which makes everything else fit into place and make perfect sense.

Understanding DR ABC also helps you prioritise casualties where multiple people need help.

Having confidence in the system allows us to be confident First Aiders and First Responders who can think on their feet and make the right decisions to help a casualty or multiple casualties.

Beyond The Primary Survey

Situations change. Sometimes people get better, sometimes they get worse. If someone changes within an incident, for example a responsive casualty becomes less responsive, we go back to the top of the the DR ABC algorithm to see what has changed and what we can do about it. Seeing the penny drop when our learners ‘get it’ and watching their confidence grow as a result is always amazing!

First Aid isn’t about having access to lots of fancy kit – it’s about being really good at the basics. Getting really good at finding and treating issues a casualty has is the cornerstone of First Aid. Getting good gives you confidence. Confident, well trained Life Saving Training First Aiders and First Responders save lives.

Fancy learning or refreshing First Aid? It’s not such a daunting prospect and we promise we’ll look after you. We’ll build you up, embed the skills you really need to know and not bamboozle you with the things you don’t!

Just get in touch for a chat, we’re always happy to help, and the more people who learn good quality First Aid – the better.

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