The Secondary Survey

The Secondary Survey

Fisrt Aid Skills

The Secondary Survey: A Step-by-Step Guide

The secondary survey is a thorough head-to-toe check to identify hidden injuries or illnesses in a responsive casualty. It involves assessing history, signs, and symptoms to ensure that no critical issues are missed.

Why the Secondary Survey Matters

Missing hidden injuries can lead to worsening conditions (internal bleeding, spinal damage). A systematic check ensures nothing is overlooked.

1. Visual & Verbal Survey

  • ASK about pain, numbness, or tingling.

  • LOOK for visible injuries (swelling, bleeding, deformities).

  • Use AMPLE to gather medical history:

    • Allergies (any known allergies & reactions)

    • Medications (current prescriptions)

    • Previous medical history (conditions, surgeries)

    • Last intake/output (food, drink, urination)

    • Event details (what happened?)

2. Signs & Symptoms Check

  • Signs (what you observe):

    • Swelling, bruising, deformity, bleeding, unusual skin color, strange odors.

  • Symptoms (what the casualty reports):

    • Pain location, type (sharp/dull), consistency, worsening with movement/breathing.

3. Spine Assessment

  • Stabilize if neck/back pain is present.

  • Check for:

    • Pins & needles, and electric shock sensations.

    • Ability to move arms/legs, push feet/hands, and make a fist.

4. Head & Face Check

  • Inspect scalp, face, jaw, and nose for swelling/bleeding.

  • Check for:

    • Loose/broken teeth.

    • Nose/ear bleeding or clear fluid (CSF—sign of skull fracture).

    • Cheekbone fractures.

5. Chest Examination

  • Observe breathing:

    • Uneven chest movement, shortness of breath, noisy breathing.

  • Ask about pain when breathing (possible rib fractures or lung injury).

6. Abdominal Check

  • Blunt trauma can cause internal bleeding (liver, spleen, intestines).

  • Look for bruising and wounds.

  • Ask about pain location.

7. Pelvic Area Check

  • Common in high-impact injuries (car crashes, falls).

  • Check for:

    • Urinary incontinence.

    • Pain, leg rotation (sign of pelvic fracture).

8. Limbs Assessment

  • Look for:

    • Deformities, swelling, dislocations.

    • Bleeding, sprains, or fractures.