When Should I Perform the Primary Assessment, Secondary Assessment, & Secondary Survey?

Question: When should I perform the primary assessment, secondary assessment (head-to-toe), and secondary survey?

Survival Med’s Answer: The primary assessment is the initial evaluation conducted as soon as possible to identify and address immediate life-threatening issues using the MARCH protocol: massive bleeding, airway, respirations, circulation, and the decision to hike out to help versus calling for emergency services like a search and rescue team or helicopter evacuation.

Ensure the person is stable before proceeding to other steps. If at any point they become unstable, reassess M-A-R-C-H.

Once the primary assessment is completed and immediate threats are managed, move on to the secondary assessment. This involves a detailed examination of injuries or illness, including a head-to-toe evaluation and focused assessment based on complaints or suspected injuries.

The secondary survey, a part of the secondary assessment, focuses on obtaining a comprehensive medical history from the person (if conscious), bystanders, or medical records. This additional information aids in providing suitable care and making informed treatment decisions.