Frederick Ding & Christopher Chan

Bronze Cross – Primary & Secondary Assessment

The purpose of a primary assessment is to preserve the life of the victim, taking action where
needed. Once the victim’s life-threatening conditions have been addressed, the rescuer must
begin the secondary assessment – monitoring his condition, gathering information and finding
other conditions that require treatment.

The Primary Assessment

The lifesaver’s first obligation is to his own safety. Upon arriving at the scene:

Area
Check for hazards in the immediate vicinity, and remove them as safely as possible.

Awareness
Assess the level of consciousness – does the victim respond to voice or touch stimulus?

Ambulance
Activate EMS, preferably using a bystander. If qualified, an AED can be retrieved at this time.

The rescuer must maintain the ABCs of all victims:

A. Airway
Keeping the airway open allows the body to take in oxygen and expel carbon dioxide. A blocked
airway can lead to respiratory or cardiac arrest.

Use the head-tilt chin-lift technique to open the airway. Check for and remove obstructions.

B. Breathing
Always use Once the airway is open, check for normal breathing, making use of the look, listen & feel
barrier techniques. Look at the chest to observe the rising and falling of normal respiration. Listen for
devices! air movement. Feel for air coming through the mouth or nose.

If there is no breathing or abnormal breathing, CPR must be initiated, beginning with 2 breaths.

C. Circulation
Oxygen-rich blood cannot be circulated without breathing. Hence, it is unnecessary to check for
a pulse to determine whether CPR is needed; commence it immediately if no breathing is detected.

If trained, The purpose here is to squeeze the heart, causing blood to circulate. Refer to the Canadian
use an AED . Lifesaving Manual for proper CPR technique.

Refer to the Canadian Lifesaving Manual. PG. 1

 Frederick Ding & Christopher Chan

Treatment of the ABCs must be continued until the victim resumes breathing independently
(unlikely with CPR alone), qualified help arrives and takes over, the rescuer becomes unable to
continue, or the rescuer puts himself at risk.

The Secondary Assessment

The secondary assessment consists of three major components: history, vital signs, and the
head-to-toe examination.

History
At this point, the victim should be sufficiently conscious to give verbal responses to questions
posed by the rescuer. A rescuer should take note of the SAMPLE questions:

Continue to Signs & symptoms

rest and Allergies
reassure. Medication
Previous medical history
Last oral intake
Events leading up to the emergency

Answers to these questions may need to be provided to paramedics or otherwise recorded.

Vital signs
Take note of changes or abnormal conditions in the following signs:
ƒ Pulse (carotid, brachial, radial) ƒ Breathing
ƒ Pupils ƒ Level of consciousness
ƒ Skin colour & temperature
If level of consciousness deteriorates, it may be necessary to recommence CPR.

Head-to-toe examination
Keep Check the victim for abnormalities (e.g. bruising or minor bleeding). Examine the head, feeling
monitoring for indentations, blood or fluid, and watch for signs of discomfort. Examine the neck; if there is
ABCs. pain there, immediately stop the examination and immobilize the neck. Check for obvious
deformities and asymmetry of the shoulders, chest, and back. Examine the arms and hands for
areas of pain or deformity. Examine the abdomen with gentle pushing and watch for pain, as
this is where many organs lie. Then, examine the pelvis, a large bone with potential for damage,
by pushing gently downward on both hips. Finally, examine the legs and feet for obvious
injuries, shortening or rotation of one leg, and check that they can be moved normally.

The Canadian Lifesaving Manual contains an excellent illustration of the head-to-toe

examination in section 6.6.

Refer to the Canadian Lifesaving Manual. PG. 2