What is the first step in the primary survey according to established protocols?

The first step in the primary survey according to established protocols is to protect the cervical spine, if indicated. This initial action is critical in any trauma situation where there is a potential for spinal injury. The rationale behind this step is to minimize movement of the spine, which can prevent further injury to the spinal cord and associated nerves. By stabilizing the patient's head and neck, responders can reduce the risk of exacerbating any existing injuries while also preparing for subsequent assessments and interventions.

Properly addressing the need to protect the C-spine sets the foundation for a thorough and safe evaluation of the patient's airway, breathing, and circulation afterward. Following this step, you would continue with assessing the airway, checking for breathing, and evaluating circulation, but ensuring the safety of the spinal column takes precedence in situations where trauma is suspected. This approach aligns with best practices in patient care protocols aimed at optimizing patient safety and outcomes.