Safe Approach: Primary Survey

Which every approach to the Primary Survey you prefer, such as DRABC or MARCH, the first step is to ensure that you make a safe approach when responding to a casualty, so as to not exacerbate the situation and to not become a casualty yourself. The approach needs to include a proper assessment of the potential risks and should not be just a “quick check” due to the potential for subtle but serious risks, such as electrocution and falling items.

It’s critical that you do not rush in. It may be the case that the situation is simply too dangerous for you to enter alone, it may be that you just require some personal protective equipment (PPE) to enter the area, or it may be that an action is required to render the area safe – such as disabling the electrical supply. The likely risks are going to vary depending on the location of the casualty.

Some examples of risks to consider are:
  • Blood and other bodily fluids
  • Environmental conditions (very cold weather, wet weather)
  • Sharp objects (needles, knifes, tools, weapons)
  • Falling from height
  • Falling items from above
  • Electricity
  • Traffic
  • Fire
  • Hazardous materials and chemicals
  • Animals (livestock and pets)

The first item of PPE before contacting the casualty should be gloves and might be all that is required, however depending on the location and circumstances there is a large amount of PPE that might reduce the risk. This may include:

  • High visibility clothing
  • Warm or waterproof clothing
  • Helmet
  • Goggles
  • Safety footwear
  • Masks (face shield, dust mask, breathing apparatus)
  • Harness and personal anchor
  • Hearing protection
  • Chemical protection
  • Fire protection
  • Ballistic protection

Whilst working through your Primary Survey, continually reassess the scene for danger. There may be a hidden danger that you did not immediately notice. If necessary to prevent yourself from becoming a casualty, extract yourself from the situation until further help arrives.