Secondary Survey

Question 1

What are the three (3) areas that make up the secondary survey?

Answer 1

• History
• Vital signs survey
• Physical examination (head-to-toe)

Question 2

Outline the mnemonics used to obtain the history in the secondary survey

Answer 2

OPQRSTT
• Onset, palliation/provocation, quality, severity,
timing, treatment (self)

SAMPLE
• signs/symptoms, allergies, medications, PMHx,
last eaten, events prior

Question 3

List the vital signs & assessment tools utilised in the secondary assessment

Answer 3

• HR • Respiration • GCS • 12-lead
• BP • Temp • SpO2 • BGL (+/- ketones)
• NIHSS-8 & MRS • COAST • SAT

Question 4

When completing a physical assessment on the head how/what do you examine & what are the common signs to look for?

Answer 4

Inspect:
General
• Bruising, lacs, deformity, facial muscle, asymmetry
Eyes
• Pupillary response, ‘racoon eyes’ = base of skull #
Ears
• Blood or cerebrospinal fluid, ‘Battle’s signs - mastoid process bruising = base of skull #
Nose
• Deformity, epistaxis
Mouth
• Loose teeth, bite malocclusion = mandibular #, airway/tongue swelling
Voice
• Hoarseness

Palpate:
• Crepitus, tenderness, subcutaneous emphysema

Question 5

When completing a physical assessment on the neck how do you examine & what are the common signs to look for?

Answer 5

Inspect:
• Bruising, deformity, laceration, raised JVP, medical alert necklace

Palpate:
• Tracheal position, bony tenderness, carotid pulse, subcutaneous emphysema, lymphadenopathy

Question 6

When completing a physical assessment on the chest how do you examine & what are the common signs to look for?

Answer 6

Inspect:
• Expansion, paradoxical movement, accessory muscle use, lacerations, bruising, deformity

Palpate:
• Tenderness, subcutaneous emphysema, bony crepitus, apex beat

Auscultate:
• Heart sounds, air entry & breath sounds, additional sounds

Question 7

When completing a physical assessment on the abdomen how do you examine & what are the common signs to look for?

Answer 7

Inspect
• Bruising, laceration, distention, priaprism

Palpate
• Tenderness, guarding, rigidity, rebound tenderness, masses

Auscultate
• Bowel sounds

Question 8

When completing a physical assessment on the pelvis how do you examine & what are the common signs to look for?

Answer 8

Inspect
• Bruising, laceration deformity

Palpate
• Bony tenderness

Question 9

When completing a physical assessment on the upper & lower limbs how do you examine & what are the common signs to look for?

Answer 9

Inspect
• Brusing, laceration, deformity, shortening, rotation, medical alert bracelet

Palpate
• Neuromuscular status, bony tenderness, crepitus

Question 10

When completing a physical assessment on the back how do you examine & what are the common signs to look for?

Answer 10

Inspect
• Bruising, laceration, deformity

Palpate
• Bony tenderness, evidence of a bony step, subcutaneous emphysema