A simple assessment method for first aiders that defines the problem and the severity, to guide further action and potentially life-saving skills.

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First Aid at Work – BURPS has been developed by leading emergency & pre-hospital care doctors for first aiders, to allow for early recognition of problems.

A key part of providing first aid is how we assess the casualty, especially if the problem is not immediately
obvious or we are unsure how serious it is. BURPS is just one of the First Aid at Work – FTACC key tools that empower first aiders to simply and quickly manage what they are called to attend.

The First Aid at Work – BURPS approach is supplemented with our unique colour coded response guide


Indicates simple First Aid measure


Indicates the need for review by a healthcare professional or hospital visit


Indicates the need for a 999 emergency ambulance and some immediate action

What does BURPS mean?

BURPS is a rapid and systematic approach to casualty assessment.
In our First Aid Training when we approach the casualty we ask:

B – Bleeding:
is there any sign of bleeding?
U – Unconscious:
is the person unconscious or very drowsy?
R – Respiratory Distress:
is the patient having difficulty breathing?
P – Pain or Numbness:
is there any pain or altered sensation anywhere?
S – Skin Changes:
any rashes, hot, cold, blisters or skin problems?

So how does BURPS compare against standard practices?

We developed the BURPS approach for the UK Police and Fire Services and
it has now been well embedded in these organisations and very well received.

BURPS moves away from the traditional ABC ‘body systems’ approach and instead it focusses on
the ‘actual problems’ that present themselves, the likely causes and the necessary
management approach.

BURPS Overview

The BURPS assessment will acknowledge serious bleeding immediately and guide the first aider through to the essential management.

In traditional approaches to first aid, this would often come later, but there has been a shift in trauma care training with an increasing realisation that in the most severe injuries blood loss can be the biggest preventable killer.

As such, with early recognition of such bleeding and prompt action, we may well be able to minimise blood loss and shock and potentially save that person, without unnecessary delays assessing airway and breathing, whilst bleeding may continue uncontrolled.

Areas Considered:

  • Minor Bleeding
  • Major Bleeding
  • Shock

The next step in BURPS assessment considers the conscious level of the casualty, in the simplest terms, to identify unconscious or very drowsy casualties who may have a life threatening airway obstruction or other serious medical problem.

Areas Considered:

  • Drowsy/unconscious
  • Fainting
  • Diabetic Hypo
  • Stroke
  • Seizures
  • Cardiac problems
  • Head injury
  • Blood loss/shock
  • Falls

The next step in BURPS assessment we consider the respiratory system looking for breathing difficulties and the most obvious causes

Areas Considered:

  • Respiratory Distress
  • Obstructed breathing – Blocked airway
  • Breathlessness – Medical causes

Pain or numbness are often things that will be causing most distress to casualties

Pain is like a big flag stuck in the patient to indicate where a problem is occurring, whereas numbness often indicates a problem elsewhere such as hyperventilation, extreme anxiety or injuries affecting the spinal cord or nerve supply to that area.

Areas Considered:

  • Pain or Numbness

The skin is often forgotten as a sign of illness, but far beyond the obvious wounds, the skin can changes in many ways such as rashes, blisters, burns, hot, cold, clammy etc

Areas Considered:

  • Wounds
  • Infection/Sepsis
  • Rashes
  • Temperature
  • Burns
  • Reactions eg allergic

Once the BURPS assessment is completed the first aider will already have a good
indication of the key issues and management.

However, several additional supporting questions can prove useful in supplementing your thoughts,
depending upon the problem including:

  • Do you have any health problems?
  • Has this ever happened before?
  • Are you taking any medication?
  • Do you have any allergies?

How does the BURPS method work in practice?

Below we have three examples of the BURPS approach in use

The findings for each condition are highlighted on the BURPS list and the colour coding indicates
the urgency and actions required.