When Disaster Strikes — First Aid: The Primary and Secondary Surveys

In First Aid there are many, many steps you can take to help someone, but how can you treat someone if you don’t know what’s wrong? That’s what the primary and secondary surveys are used for. These surveys were created as an easy and quick way to assess a victim’s state. Here’s how they work…

The Primary Survey

The primary survey is the first step you take when assessing a victim in first aid. The acronym people use to make the steps easier to remember is DR ABC. I’ll go through each of the letters to tell you their meaning.


The first letter–D–stands for Danger. When you first come upon a victim, check your surroundings. Are you or the victim in any danger? 

Things you can look for when assessing danger is:

  • Fire
  • Smoke/fumes 
  • Hostile individuals 
  • Electronics in water
  • Broken glass
  • Unsafe structures
  • Chemicals
  • Anything else that might put you or the victim in danger.

When performing first aid, always remember that you can’t help anyone else before you help yourself. 


The second step in the primary survey is Response. You have already assessed the danger of your situation, now it’s time to check the casualty. There are a few ways to check someone’s response, but the first thing you should look at is if they are conscious or unconscious. If the casualty is conscious, then you can move onto the next letter in DR ABC. If they appear unconscious, try talking to them. Ask questions and speak orders like “are you okay” or “open your eyes” directly into their ear. Try to tap their shoulders–or if they’re an infant try squeezing their foot. If they respond to any of these they are responsive, if not they are unresponsive. Remember this to later tell paramedics. 

Airways, Breathing and Circulation

These last letters in DR ABC stand for Airways, Breathing and Circulation. Firstly, you need to open the casualty airways. To do this you would use a method called the head tilt chin lift. As the name states, first you would put your hand on the victim’s head and then two fingers under their chin, then simultaneously lift their chin with your fingers and push their head down. Then open up their jaw so their mouth is open. This opens up the victim’s airways and allows them to breathe more easily. The next step is breathing. To assess someone’s breathing lean down and put your cheek right above their mouth with your face looking towards their chest. When checking for breathing, you should be watching if the casualty’s chest is moving up and down, listen for breaths and see if you can feel their breath on your cheek. 

If someone is not breathing then you should immediately start CPR, if they are breathing then you can move onto the next step of the primary survey. 

Last but not least is circulation. When checking circulation, all you need to do is look for bleeding. You can use your sense of sight, touch and/or smell to see if the casualty is bleeding or not. If they are then use the necessary steps to treat the bleeding, if not then you can move onto the secondary survey.

The Secondary Survey

The secondary survey is used to survey someone after it has been assured that they are not in any serious danger. This means they are breathing, responsive and not in any life threatening danger from bleeding. This is used for only minor injuries. The secondary survey also has its own acronym–SAMPLE. Here are the meanings behind each letter. 

SSigns and Symptoms – check for any abnormalities the casualty is experiencing. You can look for things such as swelling, discoloration, bruising, sweating, etc. Check if their pupils are dilated, equal to size or unfocused. Do they look tired? Check if their skin is abnormally cold or hot, if they are shaking, anything a healthy person usually wouldn’t experience you should take note of. You should also ask questions and give them commands to see if their verbal and motor responses are okay. Ask if they are in pain, and if yes ask questions like “Where is it?” “When did it start?” “Can you describe the pain?” 

AAllergies – Ask the casualty or anyone near they might know if they have allergies. 

MMedication – Ask the casualty or anyone near they might know if they take medication. Ask how often they should take the medication, when they last had it and how much they had taken. 

PPrevious Medical History – ask the casualty or anyone near they might know if they have had any medical accidents recently or in the past. Ask if they have had any surgeries recently, or if they have any medical problems such as diabetes, heart disease, etc. 

LLast Oral Intake – ask the casualty when they had last eaten or drank. Ask what they had consumed as well. 

EEvent History – ask the casualty or any bystanders what had happened prior to the accident. You can also look for clues nearby for what might have happened. 

If you ever come upon someone in need of help, the first thing you should do is perform DR ABC from the primary survey. Then if you’re sure they’re in no life threatening danger, go through the steps of SAMPLE from the secondary survey. Whether we like it or not accidents happen, so it’s always great to be prepared. 

Works Cited 

Canadian Red Cross. “Secondary Survey.” p. 1, https://www.redcross.ca/crc/documents/What-We-Do/First-Aid-and-CPR/Workplace/Online-Tools/fa_onlinetools_skills_summaries_secondary_survey.pdf.

St John Ambulance. “How To Do The Primary Survey (DR ABC).” https://www.sja.org.uk/get-advice/first-aid-advice/how-to/how-to-do-the-primary-survey/#:~:text=What%20is%20the%20primary%20survey,%2C%20Airway%2C%20Breathing%20and%20Circulation

St John Ambulance. “How To Do The Secondary Survey.” https://www.sja.org.uk/get-advice/first-aid-advice/how-to/how-to-do-the-secondary-survey/

Vickers, Joe. “How to Do the Primary Survey in First Aid with DRABC Steps.” Human Focus, https://humanfocus.co.uk/blog/primary-survey-with-drabc-steps/