Head to toe
A Secondary Survey can be done once you have dealt with any life-threatening injuries whilst doing your Primary Survey.
It involves a more thorough head-to-toe examination, and the aim is to detect other significant but not immediately life-threatening injuries. If during the examination any deterioration is detected, go back and reassess the primary survey.
Taking an adequate history from the patient, bystanders or emergency personnel of the events surrounding the injury can assist with understanding the extent of the injury and any possible other injuries.
- Use the SAMPLE acronym to assist with gathering information:
- Past medical history
- Last meal
- Events leading to injury
During this examination, any injuries detected should be accurately documented and any required treatment should occur, such as covering wounds, managing non-life-threatening bleeding and splinting of fractures
- abnormal breathing
- pale skin
- discoloration or deformity
- flushed skin
- slurred speech
- smell (such as alcohol)
- Is the casualty experiencing any pain?
- How does the casualty say they feel?
- Is the casualty experiencing any numbness or abnormal sensation?
The acronym SAMPLE may help you remember the important things to find out about the casualty:
- Look for any bleeding
- Head: bleeding, swelling, lesions, dents on the skull
- Ears: Look for blood or yellowish liquid which could indicate a skull fracture
- Eyes: Look at the size of the pupils. Shine a light off your phone to check if they react
- Mouth: Check for injuries, blockages, burns
- Skin: colour and temperature
- Neck: swelling, sensitivity or deformity
- Chest: Look for symmetrical chest movement when breathing, any deformity
- Collar bone, arms, fingers: swelling, dislocation, breaks, medical wrist bands
- Spine: Is there a loss of feeling in the casualty’s legs
- Pockets: Check for any medicine like an asthma pump, epi-pen or GTN spray for people with heart disease
- Abdomen: Any swelling, puncture would or bleeding
- Pelvis: Important not to move or rock this area, but check for bleeding, incontinence, signs of fracture
- Legs & Toes bleeding, swelling, deformity or soreness, movement
Important – Return regularly to the casualty’s head to check for breathing. The casualty’s condition could worsen at any time.