Primary Assessment in Emergency Care

1 May 2013, Comments: 0

First aid is defined as the “provision of immediate care to a victim with an injury or illness.” It is performed by a trained personnel or any civilian trained with the basics of first aid within a limited skill range. First aid in major cases/ scenarios is directly related to, if not almost synonymous to Emergency Care. Per definition, emergency care is a nursing intervention from the Nursing Interventions Classification (NIC) defined as providing life-saving measures in life-threatening situations.

In providing emergency care, the first aider (or in this case, the nurse) undergoes primary assessment upon administering first aid to the injured person/ persons, also called as the “casualty” or the “victim”. The following are the components of the primary assessment done by a first aider in administering first aid and emergency care.

First, the first aider must have full awareness of danger. Upon approaching the scene, he/ she should be aware of the dangers that might be posed to oneself or the victim. This includes environmental danger and human danger. Examples of environmental dangers are traffic, gas or chemical leaks, live electrical items, fire hazards, and falling objects. The latter danger involves human factors, such as bystanders in the way, uncooperative casualty, or any aggressive person in the area. Other important potential dangers to consider are body fluids; like blood, vomit, urine and feces. Body fluids can carry infections and diseases that is why it is imperative to always wear gloves. Putting on gloves is the first thing that a first aider should do when approaching a victim. It should be noted that the first priority in providing first aid is to keep one’s self protected. Therefore, first aiders are never required to place themselves in a situation. that may put them in danger. He/ she should be aware of the surroundings and the changes in the situation.

Secondly, the first aider must gather as much information as possible about the incident as he/ she approaches the scene. He/ she should look at the area for clues about what happened. If the first aider pays enough attention and/ or listens to the victim carefully, he/ she can get some history about the casualty and the incident that could be helpful in the course of treatment of the victim.

The last component in the primary assessment is the responsiveness of the victim. Assess how responsive the victim is by initially asking, “Hey! Are you okay?” Next prioritize the victim using the AVPU scale in order to be guided on what to do next. AVPU stands for: (A) Alert, responsive to (V) Voice, responsive to (P) Pain, and (U) Unresponsive. The victim is responsive if the measures to check his responsiveness using AVPU provoke reactions; such as coherent verbal response, groaning, body movement, and even fluttering of eyes. If no response, then he is categorized as unresponsive and unconscious, and thus, needs high grade emergency care. Responsive or not, the first aider must perform further checks on key life critical system of breathing and circulation.

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