In an unconscious patient, how is the primary survey (ABC) conducted?

• A. Check circulation first, then airway and breathing.
• B. Check responsiveness, then airway.
• C. Assess Airway, Breathing, and Circulation first, then check responsiveness and activate EMS if needed.
• D. Assess breathing only and call EMS.

Answer: (C)

The main idea is to use the ABC approach to rapidly identify and treat life threats in an unconscious patient. You start by ensuring the airway is open and patent, because without a clear airway oxygen can’t reach the lungs. If the airway is blocked, clear it or reposition the head and use a jaw-thrust if spinal injury is suspected.

Next you assess breathing to see if the patient is actually ventilating. Look for chest rise, listen for breath, and feel for air. If there’s no normal breathing, provide rescue breaths or initiate bag-valve-mask ventilation as needed.

Then you check circulation, focusing on whether there is a pulse and whether there is severe bleeding. If there’s no pulse, begin CPR; if there is a pulse but poor perfusion, continue with appropriate rescue measures while monitoring.

Only after addressing airway, breathing, and circulation do you reassess responsiveness and decide about activating EMS if it hasn’t been done yet. This sequence prevents missing a life-threatening airway or breathing problem and sets the stage for deciding the next steps based on the patient’s consciousness and overall stability.

If airway compromise is suspected due to neck or spinal injury, use a jaw-thrust rather than a head-tilt to open the airway.