How to do the general survey (the first look)
Other platforms explain it with text and video. In VMS you practice it on the patient.
The general survey starts at the door. In a few seconds it tells you how sick the patient is and what to check first.
Step by step
Look from the door
Is the patient in distress? Breathing hard, in pain, pale or sweaty? If so, go to the ABCs first. [1]
Level of consciousness
Awake, drowsy or hard to wake. Do they follow you with their eyes and answer? [1]
Introduce yourself
Your name and role, confirm the patient and get consent. [1]
Appearance
Looks their stated age? Hygiene, clothing for the weather, body build. [1]
Posture and movement
Sitting up to breathe, curled up in pain, tremor, gait if they walk in. [1]
Behavior and speech
Facial expression, eye contact, mood, how clear and fast they speak. [1]
Skin and odors
Color (pale, blue, yellow, red), sweating, and any odor such as alcohol or fruity breath. [1]
Vital signs and record
Take the vital signs and write a one-line summary of the first impression. [1]
Common errors
- Starting a long interview with a patient in distress.
- Not writing the first impression down.
- Judging appearance instead of describing it.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. VMS is not affiliated with these organizations. Updated: 2026-10-11.