The primary examination serves to identify life-threatening conditions and injuries and to implement emergency measures. It is done immediately after approaching the injured person and includes an assessment of the state of consciousness, airway patency and breathing, blood circulation (pulse), and the general condition of the injured person.
Checking the state of consciousness
A conscious person answers loud questions, such as: “Can you hear me?”, “What’s your name?” “Are you okay?” “What happened?” Casualty can talk to the rescuer, answer the call, react to painful stimuli or not react at all, depending on the severity of the pores of the state of consciousness. An unconscious person may or may not have preserved breathing and circulation.
After determining the state of consciousness, the primary examination is performed according to the following principles of the international ABC protocol:
- examination and assessment of airway patency, and manual fixation of the head and sciatic spine (checking whether the tongue is sunken, whether there is accumulated blood in the mouth or deeper airways, vomited stomach contents, foreign body or parts of a broken prosthesis). If there is a fall of the tongue, it is necessary to throw the victim’s head back. If a foreign body has closed the airway, it should be removed.
- assessment of respiration should not last longer than 10 seconds. Breathing check includes the following lifeguard protocol:
> listens to see if the victim is breathing;
> observes whether his chest is raised;
> under his arm he feels the movements of his chest.
The rescuer first approaches the cheek in front of the victim’s mouth and nose. He then turns his head towards his chest and the head he threw away. Breathing is controlled by the principle: “I see, I hear, I feel”. He looks at the frequency of chest movements (fast or slow), the depth of breathing (shallow or deep) and the expansion of the nostrils, listens to the quality of breathing (easy or difficult, hissing / grunting) and feels the flow exhaled air (breath) on the cheek that he placed above the lips of the casualty.
- assessment of circulation (heart rate test) is most often performed by feeling the pulse (was) with the cheekbones of two joined fingers in the following places:
> first on the common carotid artery in the cavity between the Adam’s apple and the neck muscles (lat. a. carotis communis), left or right;
> above the carotid artery (lat. a. radialis), in the area of the wrist and forearm;
> in infants and young children by listening to the heartbeat under the left nipple by pressing the ear against the chest.
Circulation check should take up to 10 seconds. It is not recommended that non-medical staff look for a pulse as this will result in much more than 10 seconds.