Secondary Survey

Question 1

What is anisocoria?

Answer 1

medical name for the pupils being different size

Question 2

What does it mean if pupils are fixed?

Answer 2

pupil is not normal in size, may not dilate or constrict in the way that it should

Question 3

Reactive pupils

Answer 3

abnormally sized pupil has some change in response to light or change in visual distance

Question 4

Dilated pupils

Answer 4

one or both pupils are abnormally large

Question 5

What can cause dilated pupils

Answer 5

alcohol, cocaine, ecstasy, LSD, MDMA, amphetamines, cannabis, inhalants, narcotics, hallucinogens, bath salts, ketamine and SSRI antidepressants

Question 6

Constricted pupils

Answer 6

one or both pupils are abnormally small

Question 7

What can course constricted pupils

Answer 7

opioids, heroin or morphine

Question 8

What illnesses and conditions can cause pupils to be unequal

Answer 8

MS, cranial nerve damage, Inflammation, increased intracranial pressure, vision loss, trauma, migraine, seizures, surgery and coma

Question 9

Normal blood glucose, hypoglycaemia and hyperglycaemia

Answer 9

Normal blood glucose: 4-8mmol/L
Hypoglycaemia: Below 4mmol/L
Hyperglycaemia: Above 9mmol/L

Question 10

Common causes of hypoglycaemia and hyperglycaemia

Answer 10

Hypoglycaemia: insufficient food intake, alcohol abuse, insulin overdose
Hyperglycaemia: infection, critical illness, self-neglect)

Question 11

How do you test blood glucose levels?

Answer 11

1. clean area with a wipe and allow the area to dry
2. depress the lancet into the patient until you hear a click
3. wipe the blood away and squeeze the finger to encourage more blood
4. load testing strip
5. dip the strip into the blood

Question 12

What is the purpose of the secondary survey

Answer 12

obtain a detailed history, perform a head-to-toe assessment, reassess vital signs to identify injuries and metabolic abnormalities

Question 13

Trauma - DCAP

Answer 13

Deformity - wrong place
Contusions - injured piece of skin or tissue
Abrasions - skin scraped off
Punctures - wound

Question 14

Trauma - BTLS

Answer 14

Burns
Tenderness
Lacerations
Swelling

Question 15

Head Assessment (Skull, ears, face, eyes, nose and mouth)

Answer 15

Skull: symmetrical, no boggy masses, look for depressions

Ears: blood, cerebral spinal fluid, hearing loss, mastoid bruising

Face: structural integrity of the maxilla and mandible

Eyes: pupils, vision, periorbital bruising

Nose: epistaxis, septal deviation

Mouth: oral damage, full airway assessment, dental damage

Question 16

What is mastoid bruising

Answer 16

bruising behind the ears - can suggest significant internal injury

Question 17

Neck Assessment

Answer 17

accessory muscle use, bruising, swelling, ligature marks, lacerations, surgical emphysema, c-spine tenderness

Question 18

What is surgical/subcutaneous emphysema?

Answer 18

The presence of gas in the subcutaneous soft tissue which can be detected by swelling of the area and crepitus on palpation