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Priority Action Approach

The Priority Action Approach (PAA) is a systematic method to dealing with various first aid related incidents. At its core, it is a methodology to ensure you deal with issues in order of their severity. In addition it ensures you don't miss a vital step that could save someone's life.

There are three essential sections:

  1. Scene Survey
  2. Primary Survey
  3. Secondary Survey

It is essential that you memorize the steps outlined in at a glance. You should be able to confidently say each step in order. This is essential for your success as a lifeguard.

Modifications to the PAA

The issue that most new guards face is that not all scenarios fit the PAA. The way the PAA is outlined does not include the additional steps and modifications for an aquatics environment.

‼️ It is important to realize the the PAA is a tool, not step-by-step approach for every scenario.

There are a couple ways that the PAA is commonly modified.

1. Removals from the Water

A large part of guarding is removing people from the water. If you wanted to fit this into the PAA it would often fit into the Scene Survey. You assess hazards/history to determine D-spine. Based on that you respond and remove from the water. Then you double check that history and put on PPE.

For unconscience spinals however you pull some parts of the primary survey into the removal by assessing breathing. The point is that aquatic related specifics often happen as part of the PAA.

2. Minor Injuries

Most facilities have separate forms for minors and majors. Minor injuries are often assessed as a mini version of the full PAA. Examples of this would be cuts, nose bleeds, etc. It would often be overkill to go through the full secondary survey in these scenarios. If they are talking and breathing with a papercut for instance you can pretty quickly check off most of the things in the primary survey as fine. When you are new it can be helpful to individually go through the survey in your head but with experience it becomes second nature.

3. Pulling Questions from the Secondary Survey into the Primary

Often in majors you are going to pull relevant questions from the secondary survey and ask them in the primary survey. For instance if someone has chest pain, I am going to ask them if they have a history of chest pain as a follow up question. I am not going to wait until the secondary survey. Think of yourself as a detective.