How to use DRABC – The Primary Survey

What is DRABC?

DRABC is a simple first aid process used to assess a casualty and decide what action to take. It helps you identify life-threatening problems quickly and ensures you act in the correct order.

DRABC stands for:

• D – Danger

• R – Response

• A – Airway

• B – Breathing

• C – Circulation

First aiders use DRABC as part of the primary survey, which you should always carry out before giving any treatment.

Why Is DRABC Important?

DRABC gives you a clear plan when someone is injured or unwell. In an emergency, it helps you stay calm and know exactly what to do next.

It allows you to:

• Protect yourself and others by checking for danger first
• Quickly recognise if someone is unconscious
• Identify breathing or cardiac emergencies early
• Know when to call the emergency services without hesitation
• Begin CPR or use a defibrillator as soon as it’s needed

What Are the Main Objectives of First Aid?

Before even thinking about administering any first aid, it is good to know what you are doing. As a calm and measured first aider, you need to think about the 3P’s.

First aid is all about:

Preserve life – Your first priority is to keep the casualty alive by ensuring they can breathe and their heart can circulate blood.

Prevent further injury – you don’t want the casualty to become even more injured. Ensure that the casualty has a good supply of oxygen and in a safe position. Ideally, it would be best if you didn’t move the casualty. If you have no other option, make sure you move the casualty carefully.

Promote recovery – Take appropriate action to support healing, such as applying dressings, using cold compresses, or placing the casualty in the recovery position until help arrives.

The Five Elements of the Primary Survey (DRABC)

D – Danger

On the first step of DRABC, you need to determine whether it is safe to approach the casualty and that yourself and anyone else isn’t in a position also to become a casualty. For example, this could be stopping any oncoming traffic, looking out for live electricity, looking out for any places you could fall or trip over.

Once you can confirm there is no potential danger, you can begin to assess the casualty.

R – Response

Next, you need to get some response from the casualty so the casualty can tell you what is wrong with them. To do this, use the AVPU scale, which will help you scale the level of response from the casualty.

• A – Alert: first of all, is the casualty moving or talking? If not, proceed to V.
• V – Voice: Try speaking to the casualty loudly and clearly to see if they respond to speech. Make sure that you are in the casualty’s eye line to see who is talking. If you get no response, proceed to P.
• P – Place: Place your hand on the collarbone of the casualty and carefully but firmly shake them. At this point, you need to continue to speak to the casualty, making them aware of who you are. P can also stand for pain if the casualty responds as if they are in discomfort. If they do not show any signs of responsiveness, proceed to U.
• U – Unresponsive: at this point, you can assume the casualty is unresponsive.

A – Airways

Now you need to investigate why the casualty is unresponsive by checking their airway. To do this, you need to place the casualty on their back and tilt their head back. Place your hand on the chin and forehead and lightly tip their head. With your fingertips on the chin of the casualty, lift their mouth open to open the airways.

B – Breathing

When the airway is open, look out for any signs of normal breathing for 10 seconds, look out for if the casualty looks to be breathing abnormally, infrequently or not at all. Start applying CPR if you notice any of these symptoms.

If the casualty is unresponsive but is breathing normally and isn’t in a state where they can be moved without damaging them further, put them into the recovery position.

C – Call 999 / Circulation

If you reach this point and the casualty isn’t breathing, you need to get someone to call 999, or if you are alone, put your phone on speakerphone and do it yourself. Never start CPR until someone has called the emergency services. If possible, get someone to go and get an AED while you speak to the emergency services and stay with the casualty alone.

DRABC – D

Some people consider the defibrillation stage as its step in the DRABC procedure, therefore calling it DRABCD. Using a defibrillator is key to keeping someone alive, and you need to take it seriously as a step.

DRABC or DRABCD?

Some first aid guidelines add D for Defibrillation, making it DRABCD.

Defibrillation is critical in cardiac arrest. An AED can restore a normal heart rhythm and significantly increase survival rates. Always use an AED as soon as one becomes available.

How to Use a Defibrillator (AED)?

Please take a look at our step-by-step guide on using an AED.

First Aid Training Courses

3B Training offers a range of First Aid Courses. Each training course covers different aspects of first aid for different sizes and types of workplace.

• Emergency First Aid – usually delivered to those who work in a low-risk environment.
• First Aid at Work – delivered to those who work in a medium-high risk environment.
• First Aid Requalification – this course is used to renew an existing First Aid at Work certificate expired.

Paediatric First Aid Training is for those who work with children and babies.

Frequently Asked Questions

Q: What are the 7 stages of the DRS ABCD Action Plan?

The DRS ABCD Action Plan in first aid involves seven key stages:

• Danger: Assess the situation for potential dangers and ensure safety.
• Response: Check for a response from the casualty by tapping or shaking them and asking loudly if they are okay.
• Send for help: If the casualty is unresponsive or in need of medical attention, call emergency services or ask someone nearby to do so.
• Airway: Ensure the casualty’s airway is open and clear by tilting their head backward and lifting the chin.
• Breathing: Check if the casualty is breathing. Look, listen, and feel for signs of breathing.
• Circulation: Assess the casualty’s circulation by checking for a pulse and normal colour in the skin.
• Defibrillation and more advanced care: If necessary, use an automated external defibrillator (AED) if available, and provide more advanced medical care as required.

These steps are crucial in assessing and responding to a medical emergency and are often used as a basic guideline in first aid training.

Q: What does DR and ABC stand for?

DRABC is an acronym used in first aid, and it stands for:

• Danger: The first step is to assess the situation for any potential dangers to yourself, the casualty, or others. Ensure that the area is safe before proceeding.
• Response: Check if the casualty is responsive. Gently tap or shake them and ask loudly if they are okay. This helps determine if they are conscious or unconscious.
• Airway: If the casualty is unconscious, ensure their airway is open and clear. Tilt their head backward and lift the chin to open the airway. This helps ensure they can breathe.
• Breathing: Once the airway is clear, check if the casualty is breathing. Look, listen, and feel for signs of breathing, such as chest rise and fall, sounds of breathing, and air movement. If they are not breathing, start rescue breathing or CPR.
• Circulation: Assess the casualty’s circulation by checking for signs of a pulse and normal colour in the skin. If there’s no pulse or signs of circulation, initiate chest compressions as part of CPR.

Q: What is the ABC approach of NHS?

• Airway: Ensure that the patient’s airway is open and clear. This involves checking for any obstructions or blockages in the throat or air passages and taking appropriate measures to maintain a clear airway, such as tilting the patient’s head and lifting their chin if necessary.
• Breathing: Assess the patient’s breathing to determine if they are breathing adequately or if there are any signs of respiratory distress. This may involve observing chest movement, listening for breath sounds, and checking for signs of adequate oxygenation.
• Circulation: Evaluate the patient’s circulation, including checking for a pulse and assessing their overall cardiovascular status. This step helps determine if the patient’s heart is beating effectively and if they have a sufficient blood supply to vital organs.

The ABC approach is a fundamental framework used in healthcare, particularly in emergency situations, to quickly assess and address life-threatening issues. It helps healthcare providers prioritise their actions to ensure the patient’s critical needs are met promptly.

We cover this procedure in a range of First Aid Courses with 3B Training. Please take a look at our upcoming course dates or find out more about what happens on a first aid course.

Q: Why Is Danger the First Step in the DRABC Framework?

Before giving any first aid, you must check that the situation is safe for you, the casualty, and anyone nearby. Hazards such as traffic, fire, electricity, unstable surfaces, or falling objects can quickly turn one emergency into several.