How to do the primary survey (ABCDE)
Other platforms explain it with text and video. In VMS you practice it on the patient.
The primary survey finds and treats what will kill the patient first. Fix each problem before moving to the next letter.
Step by step
Scene and protection
Scene safe, gloves and other protection on, call for help early. [1]
General impression and responsiveness
How sick does the patient look? Check responsiveness with AVPU: alert, responds to voice, to pain, or unresponsive. [1]
Stop major bleeding
In trauma, control life-threatening bleeding with pressure or a tourniquet right away. [1]
A: airway
Can they talk? Look for blood, vomit or swelling; open the airway and suction if needed. [1]
B: breathing
Rate, effort, chest movement, breath sounds and saturation. Give oxygen or ventilate if breathing is not adequate. [1]
C: circulation
Pulse rate and quality, skin color, temperature, capillary refill and blood pressure. [1]
D: disability
Level of consciousness, pupils, movement of the limbs and blood glucose. [2]
E: exposure
Remove clothing to look for injuries, then cover the patient to keep them warm. [1]
Decide and reassess
Decide the priority and transport. Repeat the survey after every change or intervention. [1]
Common errors
- Moving on before fixing a problem.
- Forgetting blood glucose in a confused patient.
- Letting the patient get cold after exposure.
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
- NREMT psychomotor skill sheets (EMT and Paramedic)
- AAMC Core Entrustable Professional Activities (Core EPAs)
Facts and steps follow NREMT psychomotor skill sheets (EMT and Paramedic); AAMC Core Entrustable Professional Activities (Core EPAs). VMS is not affiliated with these organizations. Updated: 2026-10-11.