Secondary Survey

Question 1

SAMPLE History and vital signs (may be completed during primary)ther

Answer 1

S - Symptoms the patient is complaining of…
A - Allergies
M - Medications
P - Past medical history
L - Last Meal, last oral intake, last bowel movement for abdomen pain
E - Events preceeding

OPQRSTA - if possible

What is the respiration rate? Depth? Rhythm?
What is the pulse rate? Rhythm? Strength?
What is the blood pressure

Question 2

Head

Answer 2

I am looking at and feeling the scalp and face. Is there any DCAP-BLS or TIC?
Are there Battle signs or Racoon eyes present?
Is there blood or fluid draining from the ears or nose?
What is the pupillary size?
Are they equal? Do they react to light?
Is there pallor, cyanosis, or diaphoresis?
Are there burns on the face? Are there any signs of burns in the nose or mouth?

Question 3

LOC

Answer 3

Is there any change in the LOC?
Is the patient responsive to verbal, pain, or unresponsive?
Are pupils equal and reactive ?
Any change in sensation or motor power?
Have there been any changes from the Primary Survey?

Question 4

Airway

Answer 4

Is the airway open and clear?

Question 5

Breathing

Answer 5

What is the rat and quality of respirations?

Question 6

Circulation

Answer 6

Is the radial pulse present, what is the rate, rhythm and quality?
Is the rate too fast, too slow?
What is the skin colour, condition, and temperature?
Can I see any significant bleeding or body fluid loss?
Is bleeding controlled?
For paediatric patents - what is the capillary refill?

Question 7

Neck

Answer 7

I am looking at and feeling the neck. Is there any DCAP-BLS or tenderness of the neck?
Are neck veins flat or distended?
Is the trachea midline or deviated?
Any change from the primary?

Question 8

Chest

Answer 8

I am looking at and feeling the chest. Is there any DCAP-BLS? TIC?
I am listening to the chest. Are breathing sounds present and equal?
Are they clear?

Question 9

Abdomen

Answer 9

I am looking at and feeling the abdomen. Is there any DCAP-BLS?
Is there tenderness or distention?
Is the abdomen soft or hard(rigid)?

Question 10

Pelvis

Answer 10

I am looking at and feeling the pelvis - (DO NOT palpate a fractured pelvis a second time)
Is there any DCAP-BLS or TIC?

Question 11

Lower extremeties

Answer 11

I am looking at and feeling the legs. Is there any DCAP-BLS or TIC?
Is CMS normal?

Question 12

Upper extremeties

Answer 12

I am looking at and feeling the arms. Is there any DCAP-BLS or TIC?
Is CMS normal?

Question 13

Reassessment Survey and On-Going Evaluation

Answer 13

Reevaluate LOC, ABC’s and all critical interventions.
Any changes?
Oxygen rate correct?
Oxygen switched to the main tank?
Open wounds sealed or dressed?
Are splints in proper position with distal pulses?
Impaled objects stabilized?
Pulse oximeter attached?
Pregnant patient tilted to the left?
Bleeding controlled?

Question 14

What is the Glasgow Coma scale? Describe each number rating in the 3 categories

Answer 14

Scoring system used to describe a Pt level of consciousness

• Eyes (E4)
  
  • 4 Spontaneously
  • 3 to speech
  • 2 to pain
  • 1 no response
• Verbal (V5)
  
  • 5 - Alert + orientated
  • 4 - Confused (speaking in full sentences)
  • 3 - random works ( doesn’t make sense for situation)
  • 2 - Sounds not words
  • 1 - unresponsive
• Motor (M6)
  
  • 6 - obeys commands
  • 5 - localize pain ( verbalize pain/hold painful area)
  • 4 - withdraws from pain
  • 3 - abnormal flexion from pain (decorticate)
  • 2 - abnormal Extension from pain (decerebrate)
  • 1 - no response