What is the first action in casualty assessment at the scene?

• A. Check for pulses only.
• B. Move the casualty to a safe area before assessing.
• C. Ensure scene safety, then perform a rapid primary survey focusing on airway, breathing, and circulation.
• D. Call for additional resources.

Answer: (C)

The first action is to ensure the scene is safe for you and the casualty, then move directly into a rapid primary survey focused on airway, breathing, and circulation. Safety comes first because you can’t effectively help someone if you or others are at risk, and you need a stable environment to assess and treat. After safety is established, a quick primary survey quickly identifies the most immediate life threats: is the airway open and unobstructed, is the person breathing adequately, and is circulation compromised (for example, due to severe bleeding or shock)? If any of these are compromised, you intervene right away—open the airway if needed, provide ventilation, control bleeding, or start CPR as indicated.

Choosing anything that suggests only checking pulses misses critical steps in the airway and breathing assessment, and moving the casualty before assessing can cause further harm. Calling for help is important, but it isn’t the first action in the assessment sequence.