OFA Level 2 Primary Survey

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As an OFA Level 2 attendant, you’re the first line of defense when a workplace injury happens. Once you’ve assessed the scene, your next steps—performing a primary survey and deciding on transport—can make a huge difference in the injured worker’s outcome.

This guide breaks down how to quickly assess a worker’s condition and determine the best transport option, following WorkSafeBC’s Intermediate First Aid standards.

The Primary Survey: A Rapid, Life-Saving Assessment

The primary survey is all about speed and precision. It’s a systematic check designed to find and treat life-threatening conditions first. Think of it as the “ABCs”—Airway, Breathing, Circulation.

1. Assess Responsiveness

The AVPU scale helps determine the worker’s level of consciousness:

  • A (Alert): Awake, aware, and answering questions? Good sign.
  • V (Verbal): Responds to your voice but seems dazed? Proceed cautiously.
  • P (Pain): Only responds to pain stimuli? This means they need immediate help.
  • U (Unresponsive): No response at all? Assume the worst—cardiac arrest until proven otherwise.

2. Airway (A) – Keep It Open

If the worker is talking clearly, their airway is likely fine—but stay alert for stridor (high-pitched wheezing) or gurgling, which could indicate obstruction.

For unresponsive workers:

  • Use the head-tilt chin-lift maneuver—unless you suspect a spinal injury.
  • If you do suspect a spinal injury, use the jaw-thrust technique instead.
  • Check for breathing—look, listen, and feel.
  • Clear obstructions—if needed, roll the worker on their side and do a finger sweep.

3. Breathing (B) – Is It Effective?

  • Check for chest rise and fall—watch closely.
  • Listen for breath sounds—normal, shallow, or struggling?
  • Feel for airflow—is air moving in and out effectively?
  • If the worker is in respiratory distress, position them for comfort and, if available, provide supplemental oxygen.

4. Circulation (C) – Stop Major Bleeding

  • Do a quick body scan for severe bleeding—apply direct pressure immediately if found.
  • Check skin color and temperature—cool, clammy skin may mean shock.
  • Control bleeding with a tourniquet if direct pressure isn’t enough.

5. Critical Interventions

At this point, if you’ve found any life-threatening conditions, you need to act fast:

  • Clear blocked airways—suction if necessary.
  • Start CPR if needed—use an AED if available.
  • Control severe bleeding—direct pressure or a tourniquet.
  • Handle anaphylaxis—administer an epinephrine auto-injector if required.
  • Consider spinal stabilization—especially for falls, impacts, or head injuries.

Modified Primary Survey for Walk-In Workers

If a worker walks into the first aid room on their own, the primary survey can be modified:

  • Airway: If they’re speaking normally, it’s likely clear.
  • Breathing: If they’re talking in full sentences, breathing is adequate.
  • Circulation: Check skin color and ask about other injuries.

Making the Right Transportation Decision

Once you’ve stabilized the worker, the next question is: How do we get them to further medical care?

Factors That Affect Transport Decisions

  • The worker’s condition—stable or deteriorating?
  • Company emergency procedures—some sites require ambulance activation immediately.
  • Worksite location—are you near a hospital, or out in the middle of nowhere?
  • Mechanism of injury—severe trauma may require rapid transport.

Transport Options

  • Ambulance: For life-threatening conditions or when rapid transport is essential.
  • Emergency Transport Vehicle (ETV): Often used in remote locations where an ambulance may take too long.
  • Company vehicle or taxi: For minor injuries that don’t require urgent medical attention.
  • Return to work: If the injury is minor, the worker may be able to continue their shift after proper treatment.

Rapid Transport Criteria – When Time Is Critical

Certain injuries or incidents require immediate transport:

Mechanism of Injury Red Flags

  • Pedestrian, motorcyclist, or bicyclist hit at 30 km/h (20 mph) or more
  • Severe crush injuries
  • Smoke or toxic gas inhalation
  • Electrical injuries or electrocution
  • Drowning or decompression illness

Anatomical Criteria

  • Severe brain injury (low Glasgow Coma Score, skull fracture, or paralysis)
  • Major burns—especially third-degree burns over 2% of the body
  • Amputations—excluding minor ones like a finger or toe
  • Spinal injuries—suspected paralysis
  • Penetrating eye injuries

Physiological Criteria

  • Decreased consciousness—worker isn’t responding with clear speech
  • Signs of shock—rapid pulse, pale skin, or confusion

Communicating with Emergency Services

When calling for an ambulance or ETV, be clear and concise:

  • Number of injured workers
  • Exact location
  • Nature of injuries
  • Worker’s name and age
  • Vital signs (consciousness, breathing, skin condition)
  • How the injury happened

Also, assign someone to meet the ambulance and guide them to the scene.

Ongoing Monitoring and Reassessment

While waiting for transport, continuously check ABCs every five minutes.

  • Watch for changes—improvement or deterioration.
  • Keep the worker calm and reassured—emotional support matters.

Documentation – Keep Records Straight

Accurate documentation is key for legal and medical reasons.

  • First Aid Record—incident details, injuries, treatment, and transport method.
  • Patient Assessment Chart—vital signs and changes over time.

Special Considerations for First Aid Attendants

Be prepared for specific types of injuries and emergencies:

  • Spinal injuries—always suspect spinal trauma in falls or collisions.
  • Head injuries—watch for concussion or brain injury signs.
  • Internal bleeding—look for shock, pain, and bruising.
  • Environmental emergencies—hypothermia, heatstroke, or poisoning.
  • Medical conditions—stroke, seizures, diabetes, or anaphylaxis.
  • Critical Incident Stress—take care of yourself after tough calls.

Final Thoughts – The Role of an OFA Level 2 Attendant

Mastering the primary survey and transport decision-making is essential for OFA Level 2 Vancouver first aid attendants. Your role is to identify life-threatening conditions, act quickly, and get injured workers the right care as fast as possible.

By following these steps and staying sharp through ongoing training, you’ll be ready to handle whatever comes your way. Stay prepared, trust your training, and keep saving lives. 🚑

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