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Part of PTC Course

The Secondary Survey is a head to toe and systems examination with the aim of identifying all injuries that have not been detected in the Primary Survey.

The Secondary Survey is undertaken when the Primary Survey is completed and the Airway, Breathing and Circulation are stable. If the patient deteriorates during the Secondary Survey, then you should STOP immediately and repeat the Primary Survey.

Documentation is required for all procedures undertaken.

Take a brief history of the cause of injury and a relevant patient history.

Assessment[edit | edit source]

Conduct thorough examination of each the following systems.

Head Examination[edit | edit source]

Scalp and ocular abnormalities

External ear and tympanic membrane

Maxillofacial injuries

Neck Examination[edit | edit source]

Penetrating wounds

Subcutaneous emphysema

Tracheal deviation

Neck vein appearance

Pain / tenderness

Neurological Examination[edit | edit source]

Brain function assessment using the Glasgow Coma Scale (GCS)

Spinal cord motor activity

Sensation and reflex

Chest Examination[edit | edit source]

Clavicles and all ribs

Breath and heart sounds

Abdominal Examination[edit | edit source]

Penetrating wound of abdomen requiring surgical exploration

Signs of blunt trauma and hidden haemorrhage

Genital examination

Rectal and vaginal examination

Examination of Pelvis And Limbs[edit | edit source]

Fractures and pain

Peripheral pulses

Evidence of weakness, loss of function or sensory change

Spinal Examination[edit | edit source]

Log roll and check each vertebral level for injury

Rectal Examination[edit | edit source]

Perform rectal examination (if not already done)

Investigation[edit | edit source]

Relevant further investigation includes the following domains:

Imaging[edit | edit source]


X-Ray chest, cervical spine and pelvis

Other X-rays as clinically indicated

Ultrasound (FAST)

CT Scan (If available)

Blood Tests[edit | edit source]

Any additional investigations

Other[edit | edit source]


Procedures[edit | edit source]

Relevant procedures include:

  • Nasogastric tube for abdominal decompression
  • Urinary Catheter for urine output
FA info icon.svg Angle down icon.svg Page data
Authors Matthew Arnaouti
License CC-BY-SA-4.0
Language English (en)
Translations Arabic
Related 1 subpages, 5 pages link here
Impact 253 page views
Created October 8, 2022 by Matthew Arnaouti
Modified February 17, 2023 by Emilio Velis
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