First Aid Guru

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Episode 5 of 14 · 5 min read

The Primary Survey (DRABC) and Recovery Position

The primary survey is the first check you make on any casualty, looking for anything life-threatening. Remember it as DRABC: Danger, Response, Airway, Breathing, Circulation.

DRABC step by step

  1. 1

    D. Danger.

    Before you approach, scan for gas, glass, fire, wire, traffic, anything that could hurt you or the casualty further.

  2. 2

    R. Response.

    Speak into both ears: "Hello, can you hear me? Can you open your eyes?" Ask them to squeeze your hand. No answer? Place your hands on their shoulders and give a gentle shake. Still nothing means they are unresponsive: shout for help now.

  3. 3

    A. Airway.

    Check the mouth. If there is vomit, roll them away from it or into the recovery position to clear it. Then open the airway: one hand on the forehead, two fingers under the chin, tilt the head back and lift the chin. This alone can save a life, because an unresponsive casualty's tongue can relax and block the throat.

  4. 4

    B. Breathing.

    Look, listen and feel for normal breathing for 10 seconds: watch the chest, listen closely, feel for breath on your cheek. Not breathing normally? Send for an ambulance and a defibrillator and start CPR.

  5. 5

    C. Circulation.

    Breathing normally? Check for severe blood loss: pooling blood or damp clothing that could hide a bleed. Treat any serious bleed you find.

The recovery position

An unresponsive casualty who is breathing normally goes into the recovery position. On their side, the tongue cannot block the throat and vomit drains away instead of choking them.

  1. 1

    Move the nearest arm up and out of the way, wherever it naturally goes.

  2. 2

    Take the far hand, link fingers, and place the back of it against their cheek.

    Keep your hand there through the whole turn. Turn any large rings away from the cheek first.

  3. 3

    Lift the far knee and bring that foot close to their bottom.

    The bent leg is your lever: whatever your size, pushing down on the knee turns the casualty towards you.

  4. 4

    Roll them towards you, then check the airway is still open.

    Make sure the chin is off the chest. You can watch their breathing with a hand in front of the face and by the rise and fall of the chest.

Recovery position details that matter

  • Empty bulky pockets (keys, phone) or roll them onto the other side, and consider removing glasses
  • Roll onto the injured side down if they have an injury, where possible
  • A heavily pregnant casualty always goes onto her LEFT side, to protect blood supply to mum and baby

Do

  • Shout for help as soon as you find someone unresponsive
  • Open the airway before you check breathing
  • Give the full 10 seconds to the breathing check

Don't

  • Do not put yourself in danger to reach a casualty
  • Do not leave an unresponsive casualty on their back unattended
  • Do not assume someone making occasional gasps is breathing normally: they are not

Common questions

What does DRABC stand for?

Danger, Response, Airway, Breathing, Circulation. It is the order of checks in the primary survey: make sure the scene is safe, check if the casualty responds, open the airway, check breathing for 10 seconds, then check circulation for severe bleeding.

When do you use the recovery position?

When a casualty is unresponsive but breathing normally. It keeps the airway open and lets fluids drain. A heavily pregnant casualty goes onto her left side.

How long do you check breathing for?

Ten seconds, using look, listen and feel: watch the chest, listen for breath, and feel for it on your cheek.

Related skills

CPR & DefibrillatorSecondary AssessmentAction in an Emergency

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First Aid Guru guides support learning and refreshing your knowledge. They are not a substitute for regulated, hands-on first aid training or for professional medical advice. In an emergency call 999 (UK) and follow the call handler's instructions.