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Emergencies and resuscitation

How to do the primary survey (ABCDE)

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

EMS (NREMT)MD / DOPANursing (NCLEX)
Practice it in VR with Blocky

The primary survey finds and treats what will kill the patient first. Fix each problem before moving to the next letter.

Step by step

  1. Scene and protection

    Scene safe, gloves and other protection on, call for help early. [1]

  2. General impression and responsiveness

    How sick does the patient look? Check responsiveness with AVPU: alert, responds to voice, to pain, or unresponsive. [1]

  3. Stop major bleeding

    In trauma, control life-threatening bleeding with pressure or a tourniquet right away. [1]

  4. A: airway

    Can they talk? Look for blood, vomit or swelling; open the airway and suction if needed. [1]

  5. B: breathing

    Rate, effort, chest movement, breath sounds and saturation. Give oxygen or ventilate if breathing is not adequate. [1]

  6. C: circulation

    Pulse rate and quality, skin color, temperature, capillary refill and blood pressure. [1]

  7. D: disability

    Level of consciousness, pupils, movement of the limbs and blood glucose. [2]

  8. E: exposure

    Remove clothing to look for injuries, then cover the patient to keep them warm. [1]

  9. Decide and reassess

    Decide the priority and transport. Repeat the survey after every change or intervention. [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

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

Sources

  1. NREMT psychomotor skill sheets (EMT and Paramedic)
  2. 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). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.