1 Trauma Scene Safety and Initial Assessment
Learn how to approach a trauma scene safely, summon help, identify urgent threats, prioritize first aid, and monitor injured people until professional responders arrive.
Recognize the priorities
Trauma may involve severe bleeding, fractures, head or spinal injury, burns, or several injuries at once. A rescuer’s first priorities are to avoid becoming another casualty, summon emergency help, identify immediate threats to life, and keep reassessing until professional help arrives.
Check the scene before approaching
Pause before approaching and check for moving traffic, fire or smoke, unstable structures, downed electrical wires, weapons, hazardous substances, or ongoing violence. Use available protective equipment, such as gloves, and avoid contact with blood when possible. Check how many people are injured and whether additional help may be needed.
If the scene is unsafe, stay at a safe distance and tell emergency dispatchers what you see. Do not enter until it is safe or trained responders direct you to do so.
Call for emergency help
Call 911 in the United States if someone is unresponsive, is not breathing normally, has , or may have another serious injury. When others are present, assign one person to call and another to bring an available first-aid kit or automated external defibrillator (AED).
Give the dispatcher the exact location, number of injured people, visible hazards, and what you have observed. Follow the dispatcher’s instructions and do not end the call until told to do so.
Assess the person and act within your training
Once it is safe to approach, introduce yourself and ask permission to help if the person is responsive. Form a quick impression: Is the person awake? Are they breathing normally? Is there severe bleeding? A person who does not respond, is only gasping, or has needs immediate action and emergency care.
Follow your training. For example, begin CPR and use an AED for an unresponsive person who is not breathing normally. Check for severe bleeding early; firm, steady direct pressure is a basic first-aid measure while help is being arranged. Use a tourniquet or pack a wound only if trained and appropriate to the injury.
If the person is awake and has no obvious immediate life threat, ask what happened and about symptoms, allergies, medications, and relevant medical conditions. Look for injuries without asking the person to move painful areas.
Prioritize care
Treat life threats before less urgent injuries. If the scene is unsafe, withdraw and get professional assistance. Abnormal or absent breathing, unresponsiveness, and severe bleeding require urgent emergency response and care within your training. Suspected head, neck, spinal, chest, abdominal, or major bone injuries need prompt professional assessment, even if the person seems alert. Once immediate threats are addressed, provide appropriate first aid for less urgent injuries and keep monitoring the person.
When several people are injured, call for additional emergency resources and report the number of people and the apparent severity of their injuries. Give immediate attention to life-threatening problems that you can safely address; do not spend a long time on one person’s minor injury while another has an obvious life threat. Formal multi-casualty systems are intended for trained responders, so follow their directions and the dispatcher’s instructions.
Monitor and hand over care
Stay with injured people when it is safe. Keep them as still and comfortable as possible, protect them from becoming too cold or too hot, and reassure them. Do not give them food or drink.
Continue checking breathing, responsiveness, and bleeding because a person’s condition can worsen. When EMS arrives, briefly report what happened, the injuries you noticed, changes in the person’s condition, and the first aid given. Avoid unnecessary movement when a is possible.