![]() ![]() If the patient is alert or responsive to verbal stimuli, have the patient open the mouth to assess the airway.Maintain c-spine protection, if indicated, either manually or with an appropriate-size cervical collar.Assess the patient’s level of alertness using the AVPU scale to indicate whether the patient is alert (A), responds to verbal stimuli (V), responds to painful stimuli (P), or is unresponsive to all stimuli (U).The steps below follow the widely used mnemonic A-B-C-D-E: undefined#ref7">7Ī = airway and alertness with simultaneous cervical spine (c-spine) protectionĬ = circulation and control of hemorrhageĪ = Airway and Alertness with Simultaneous C-spine Restriction Perform the primary assessment using a systematic approach to ensure that no step is forgotten.If a massive hemorrhage is present, apply direct pressure or a tourniquet as needed to control bleeding. ![]() Perform an across-the-room assessment upon the patient’s arrival to quickly identify any life-threatening conditions such as uncontrolled hemorrhage.Don additional PPE based on the patient’s need for isolation precautions or the risk of exposure to bodily fluids. If the scene is potentially unsafe, alert the proper authorities to secure the scene so that the patient may be safely approached. If the primary assessment will take place at the scene of the incident, assess the scene for environmental hazards.Encourage questions and answer them as they arise.Explain the procedure to the patient and family, and why it is being performed, as time and the patient’s condition allow.If the patient has been injured, instruct the patient to avoid moving until a spinal cord injury has been ruled out.To ensure that the primary assessment is thorough, a systematic approach should be taken, for example, following the widely used A-B-C-D-E mnemonic outlined in the procedure steps. The primary assessment is done at the initial point of patient contact and may be done again after the patient is transferred from the care of one team to another (e.g., when the emergency medical services team hands off the patient to the emergency department team members). The primary assessment is intended to assess and intervene rapidly for life-threatening conditions in critically ill or injured patients. Stabilize the cervical spine throughout the procedure if injury is suspected.ĭo not proceed to the next assessment step until interventions for life-threatening conditions have been implemented. The presence of an environmental hazard (e.g., fire, noxious fumes, potential for explosion, active shooter) that mandates immediate evacuation of the area takes priority over the primary assessment. Don appropriate personal protective equipment (PPE) based on the patient’s signs and symptoms and indications for isolation precautions. ![]()
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