Primary survey

The primary survey constitutes the first action in the diagnosis and treatment of life-threatening problems.

The patient is usually brought into hospital by ambulance having already received first aid and been strapped to a spinal board.

On first encountering the patient it is possible to establish some idea of the patient's condition, i.e. if the patient is talking coherently then there is an adequate airway, breathing and cerebral circulation. Similarly, if the patient is cyanosed then there is likely to be an airway problem.

An outline of initial management involves:

• Airway - secure a clear airway and control cervical spine
• Breathing - treat hypoventilation, severe chest injury
• Circulation - control haemorrhage and treat shock
• Disability / neurology - assess disability
• Exposure and Environment control - completely undress the patient but prevent hypothermia