Assessing an incident
This domain tests the structured first assessment of a casualty and scene. The exam wants the primary survey in the right order, recognition of life threats, and a clear decision about when to call for help. Assessment is not a one-off check; it is repeated as the casualty’s condition changes.
Core rules and concepts
- Danger first. Do not approach until you have considered traffic, fire, electricity, hazardous substances, animals, and violence. If the scene is unsafe, withdraw and call for help.
- Primary survey: DRABC. Danger, Response, Airway, Breathing, Circulation. In first aid, catastrophic external bleeding is controlled as a priority alongside the airway and breathing checks.
- Response: use AVPU - Alert, responds to Voice, responds to Pain, Unresponsive. Shake shoulders gently and ask loudly.
- Airway: in an unresponsive casualty, open the airway with head tilt and chin lift, unless a spinal injury is suspected; then use jaw thrust if trained.
- Breathing: look, listen, and feel for no more than 10 seconds. Agonal gasps are not normal breathing; treat as cardiac arrest.
- Circulation: check for severe bleeding, skin colour, temperature, and signs of shock. A lay first aider does not need to check a pulse.
- Call for help early. If the casualty is unresponsive and not breathing normally, call 999, send for an AED, and start CPR.
- Secondary survey: after life threats are managed, gather history, check head-to-toe, and record findings.
Worked example
A runner collapses at the finish line. The first aider checks danger, confirms unresponsiveness, opens the airway, and observes for 10 seconds. There are occasional gasps but no normal breathing. They treat this as cardiac arrest, call 999 on speakerphone, send for the AED, and begin chest compressions. Reasoning: gasping is not normal breathing; waiting for a pulse or a second opinion delays CPR.
Traps that cost marks
- Spending time checking a pulse instead of assessing breathing.
- Mistaking agonal gasps for normal breathing.
- Moving a casualty before the primary survey unless there is immediate danger.
- Missing severe bleeding while focusing only on the airway.
- Forgetting to repeat the assessment after treatment.