What is "during a primary assessment?

During a primary assessment, the goal is to quickly identify and treat any immediate life-threatening conditions. This initial evaluation follows a structured approach, typically using the mnemonic ABCDE.

• Airway: Ensuring a patent airway is the first priority. Look for signs of obstruction such as stridor, gurgling, or the inability to speak. Interventions might include opening the airway using a head-tilt/chin-lift or jaw-thrust maneuver, suctioning, or inserting an airway adjunct (e.g., oropharyngeal or nasopharyngeal airway).
• Breathing: Assess the rate, depth, and effort of breathing. Look for signs of respiratory distress such as accessory muscle use, retractions, or paradoxical chest movement. Auscultate lung sounds to identify any abnormalities. Interventions might include providing supplemental oxygen, assisting ventilations with a bag-valve mask, or addressing underlying causes of respiratory distress (e.g., tension pneumothorax).
• Circulation: Evaluate the patient's circulatory status by assessing pulse rate and quality, skin color, temperature, and capillary refill. Control any obvious bleeding. Check for signs of shock, such as tachycardia, hypotension, and altered mental status. Interventions may include initiating CPR, controlling bleeding with direct pressure, and administering intravenous fluids.
• Disability: Briefly assess the patient's level of consciousness and neurological function using the AVPU scale (Alert, Verbal, Pain, Unresponsive) or the Glasgow Coma Scale (GCS). Check pupillary response. This step helps identify potential head injuries or neurological deficits.
• Exposure: Expose the patient to fully visualize any injuries while maintaining patient privacy and preventing hypothermia. This may involve cutting away clothing as needed.