Conducting an accident scene survey and a primary survey of a baby or child

How to conduct a scene survey

You need to stay safe in order to help. When arriving at the scene of an accident involving a child or baby, it is important to ensure your safety first! You cannot help anyone if you become a child. Once it's safe for you, then you can consider the safety of the child and bystanders.

Control the situation.

Try not to panic and observe the situation for a few seconds. Look for dangers, risks, and hazards. Examples include the risk of moving traffic, electricity, or fast-moving water.

Gather information

Gather information from the child and/or bystanders at the scene. Use the principles of history, signs, and symptoms to identify what’s happened.

History: asking the child or witnesses for information about the incident
Signs: visual and other senses What injuries can you see? What objects are nearby that may indicate something has happened?
Symptoms: What are the child’s symptoms?

Protect and prioritise

Protect yourself and the child by minimising the risk of infection. Wear gloves and use sterile equipment from a first aid kit, if possible. Ensure casualties are prioritised using the principles of the 3 B's: breathing, bleeding, and broken bones.

important in an emergency situation. FOLLOW THE ABOVE STEPS AND TRY TO BE AS CALM AS POSSIBLE. You will be far more effective this way.

Consent:

When offering any assistance to a child who is conscious, it is important to seek their permission for you to provide first aid management. If the child is unconscious, too young, or in a life-threatening situation, you should act immediately and presume that they would prefer you to offer any assistance.

When offering first aid management to people under the age of 18, consent should also be sought from their parent or guardian, when available.

Call 999 or 112 if you’re worried about anyone who is not willing to cooperate.

How to conduct a primary survey on an infant or child

When you find a child or baby child, it is important to perform a primary survey. This is a systematic assessment to safely assess whether someone has life-threatening injuries.

Important: In first aid terms, a baby is anybody up to the age of one (1) year. A child is aged between one (1) year and eighteen (18).

The order of the primary survey is intentional; it allows you to consider each body system in order of priority, assessing first those injuries that will cause fatality, i.e., airway and breathing. The contents and order of the primary survey can be easily remembered by using the mnemonic DR.ABCD.

D: Danger:

Ensure safety for yourself and others. Do not put yourself at risk.

Remove the danger if it is safe to do so.
Find out what has happened from witnesses or the environment, if possible. Gather information.

R: Response:

Is the child responsive (conscious)?

Gently shake each shoulder and ask loudly, “Can you hear me? Open your eyes.”

If the child is a baby, you can clap loudly or gently blow in the baby’s face or tickle the sole of their feet or palms of the hand.

Assess the child’s level of consciousness using the AVPU score (see levels of response AVPU).

A: Airway

Make sure the child's airway is clear of obstruction.

Loosen any tight clothing around the neck area.

Carefully open the airway by gently tilting the head back with one hand on the child’s forehead, and lift the chin by placing two fingers under the point of the chin.

DO NOT OVEREXTEND OR TILT A BABIES HEAD.

Leave a baby's head in a neutral position.

B: Breathing

Keeping the casualties head and chin tilted (UNLESS IT IS A BABY)

Look, listen, and feel for normal breathing for up to 10 seconds.

Note: In the first few minutes after cardiac arrest, you may hear infrequent, noisy gasps. These are known as “agonal” gasps and are not the same as normal breathing.

If in doubt, start CPR.
If the child is unresponsive and breathing normally, place them in the recovery position.
Important: If the child is not breathing, you must call or ask someone to call 999 or 112 for emergency help and start CPR immediately.

C: Circulation

Identify and treat any life-threatening circulation problems, such as severe bleeding. Then commence CPR.

D: Defibrillator:

Attach an AED (automatic external defibrillator) as soon as it arrives, if it is available at your workplace. Follow the voice prompts.
An AED is a machine that can be used to shock someone’s heart back into a normal rhythm. Defibrillators are found in many public places, such as train stations and shopping centres.
Once opened, the machine gives full instructions on what to do. An AED can be used on children over a year old. If the child is one to eight years old, use paediatric pads, placing one pad in the centre of the child’s back and the second pad over the centre of their chest.

When and how to call for help

If the child is unconscious, you should call the operator so that you can relay vital information to the operator.

Calling the operator

999 or 112 will get you through to an emergency operator.
When you call the emergency operator, try to keep calm and articulate as best you can. The call-handlers are very helpful and will lead the conversation.
Do not put the phone down until you are told to do so. Use a loudspeaker.

How to Conduct a Scene Survey & Infant and Child Survey

On Unii's Paediatric First Aid Journey, we cover the crucial elements of the primary survey and DR ABC.