PATIENT
ASSESSMENT
Primary Assessment
The primary assessment
A rapid, systematic check for life-threatening
conditions that begins as you get closer to the
patient
 Includes a systematic check of the vital areas of
the body
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Priorities
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Danger
Airway
Breathing
Circulation
Major bleeding
Level of consciousness
Spinal column
Take action to manage priority problems as they are
found
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Part 1 - Approach
Approach the patient
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Approach the patient face to face
Obtain permission.
 "I am a Canadian Ski Patroller trained in first aid. May I help
you?“
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Where do you hurt?
 "Please do not move until I have checked you for injuries.“
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Assess the patient in the position found
 "I am going to hold your head to remind you not to move and
prevent further injury.“
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Apply manual cervical spine (C-spine) control, if
indicated
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Ask
"What is your name?“
 "Can you tell me what happened?“
 "When did it happen?“
 "Can you take a deep breath? … How did that
feel?“
 "Do you hurt anywhere else? … Have you had
this before?“
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C-Spine
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"Do you have any pain or tingling in your neck or back?“
"Can you wiggle your fingers and toes? “
“Can you feel your fingers and toes?“
With your free hand examine the neck
 Are the muscles rigid?
 Does the exam cause the patient further discomfort or anxiety?
 Does touching cause numbness or a tingling sensation?
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Treat for a C-spine injury as appropriate
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A cervical spinal injury is unlikely
if…
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Freely moving their head without apparent pain
No loss of consciousness
Completely alert
No alcohol or other drugs,
No tenderness or deformity of the spine
No other painful injuries which may mask neck or back
pain
No loss of sensation or movement in the limbs
If you are unsure, immobilize
If you have no concerns for C-spine injury, you may
remove your hand
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Approach Unconscious Patient
“If you can hear me, please do not move, I am
here to help you!”
 Ask all the same questions.
 Ask bystanders:
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 What is the casualty’s name?
 What happened?
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ABCD
Preliminary check of Airway, Breathing,
Circulation, and Disabilities
 If the patient is responsive, ABCs are obviously
present and the patient is conscious
 Quality has yet to be assessed
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Check the quality of the ABCDs
A - Check for and establish a clear airway
 B - Look, listen, and feel for presence of
breathing for at least 10 seconds
 C - Are pulses present? (What is their quality at
the neck and wrist?)
 What is the patient’s level of consciousness
(LOC) and are the spinal functions intact?
 Assess the need for oxygen if breathing or
circulation seems abnormal
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Immediate Action
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As you assess the patient during the Primary
Assessment, take action to correct problems as
you find them
 If the airway is noisy: reposition it with the appropriate
precautions to try to clear it
 If breathing is absent: start AR
 If the pulses are absent: start CPR
 If vessels have been cut and there are large amounts
of blood, control the bleeding
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Demo &
Practice
Part 2 – Core Area
This is a rapid assessment of the core areas of
the body for life-threatening injuries
 Throughout each step, check for signs and
symptoms of injury
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 A sign is something you observe
 A symptom is something the patient tells you
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Finding Injuries
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LOOK for:
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Deformities
Contusions
Abrasions
Punctures
Burns
Lacerations
Swelling
FEEL for:
 Tenderness
 Instability
 Crepitus
After examining each part of the body, check your gloves for
signs of bleeding and wetness
Listen to what the patient has to say
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Neck
Look for DCAP BLS
 Feel for TIC
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Back
Look for DCAP BLS
 Feel for TIC
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Chest
Look for DCAP BLS
 Also look for paradoxical movement
 Feel for TIC
 Also feel for subcutaneous
emphysema
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Abdomen
Look for DCAP BLS
 Feel for guarding, tenderness, and
rigidity
 Also check for distention and
evisceration
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Check all four quadrants
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Pelvis
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Look for DCAP BLS
Feel for TIC
Femurs
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Look for DCAP BLS
Feel for TIC
Pelvis and femur fractures are highenergy injuries
Potential for large amounts of blood loss
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Demo &
Practice