The Initial, or Primary, Survery is a rapid evaluation to quickly identify life or limb threatening injury.
The Primary survey consists of ABCDE:
- Airway - evaluation of the airway includes ensuring the airway is unobstructed, the trachea is midline, and if necessary, securing the airway either with a supraglottic device, endotracheal intubation, or if necessary, cricothyrotomy/tracheostomy
- Breathing - ensuring breathing is normal. This includes observing the breathing pattern, effectiveness, and listening to the lungs. One should also observe the chest for abnormal mechanics
- Circulation - look for any obvious sources of hemorrhage and apply pressure, if necessary. Also, look at overall perfusion.
- Disability - a quick mental status evalution. Adult Trauma Life Support (ATLS) recommends using the AVPU mnemonic - Alert, responds to Verbal stimuli, responds to Painful stimuli, or Unresponsive.
- Exposure - remove all clothing, rapid anterior and posterior examination, and cover with warm blankets.
The primary survey can usually be completed in a matter of a few seconds if a patient is well appearing.