ABCDE Primary Survey: A Structured First Assessment and Escalation Guide

Coverage update: 17 September 2026

The ABCDE approach prioritises immediately life-threatening problems before a complete diagnosis is available. It is a sequence for assessment, intervention, reassessment and early escalation—not a one-time checklist.

A — Airway

Assess whether the patient can speak, look for obstruction and consider cervical-spine risk when clinically relevant. Call for skilled airway support early when patency or protection is uncertain.

B — Breathing

Assess respiratory rate, work of breathing, symmetry, oxygenation and relevant chest findings. Treat urgent abnormalities according to local protocol and reassess response.

C — Circulation

Evaluate pulse, blood pressure, perfusion, bleeding and shock features. Obtain appropriate access and investigations without delaying immediate haemorrhage control or escalation.

D — Disability

Rapidly assess consciousness, pupils, glucose and seizure activity. A change in mental status can reflect hypoxia, hypoglycaemia, shock, neurological disease, drugs or other causes.

E — Exposure

Expose sufficiently to identify injuries, rash, infection or bleeding while preventing heat loss and preserving dignity.

Reassessment and documentation

After each intervention, return to the start of the sequence. Record time, observations, actions, response and the senior/team contacted. Local emergency protocols and available competencies govern treatment choices.

Open the complete ABCDE and SAMPLE clinical module.

Source

Resuscitation Council UK: ABCDE approach

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Featured image: Luis Melendez via Unsplash.

Last reviewed: 19 September 2026

Medical disclaimer: This article is for professional education and news interpretation only. It does not replace patient-specific assessment, local protocols, prescribing information or specialist advice.

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