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Head-to-toe assessment and vital signs

How to do the general survey (the first look)

Other platforms explain it with text and video. In Making Synapses you practice it on the patient.

Nursing (NCLEX)MD / DOPAEMS (NREMT)
Practice it in VR with Blocky

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

  1. Look from the door

    Is the patient in distress? Breathing hard, in pain, pale or sweaty? If so, go to the ABCs first. [1]

  2. Level of consciousness

    Awake, drowsy or hard to wake. Do they follow you with their eyes and answer? [1]

  3. Introduce yourself

    Your name and role, confirm the patient and get consent. [1]

  4. Appearance

    Looks their stated age? Hygiene, clothing for the weather, body build. [1]

  5. Posture and movement

    Sitting up to breathe, curled up in pain, tremor, gait if they walk in. [1]

  6. Behavior and speech

    Facial expression, eye contact, mood, how clear and fast they speak. [1]

  7. Skin and odors

    Color (pale, blue, yellow, red), sweating, and any odor such as alcohol or fruity breath. [1]

  8. Vital signs and record

    Take the vital signs and write a one-line summary of the first impression. [1]

Common errors

Practice it in Making Synapses

In Making Synapses 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.

Making Synapses cases that train this skill

612 Making Synapses cases train this skill: open the case library

Sources

  1. Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)

Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.