Secondary Survey: Head to Toe Examination

Question 1

What does the Initial Assessment consist of ?

Answer 1

Further history and external clues (medication, inhalers, medical alert bracelets)

Question 2

What is the order of the areas to be examined (with gloves) following assessment of breathing and pulse and ensuring of adequate exposure, ?

Answer 2

Scalp, ears, ears, eyes, nose, mouth, skin, neck, chest, shoulders and clavicles, arms/hands, back, abdomen, pelvis, legs and feet

Question 3

When should secondary survey be performed ?

Answer 3

In an unconscious casualty once airway, breathing and circulation have been assessed and any problems dealt with

Question 4

What does MIST stand for when handing over a casualty to paramedics?

Answer 4

Mechanism of injury
Injury found or suspected
Vital signs (pulse rate, respiratory rate)
Treatment given

Question 5

What are the three priorities in a bleeding casualty ?

Answer 5

Stop the bleeding, prevent and minimise effects of shock, arrange urgent ongoing medical care

Question 6

Which measures should be taken in a bleeding casualty ?

Answer 6

Apply pressure. Raise wound above level of the heart to reduce bleeding. Lay casualty down and raise feet to increase venous return. Bandage pad/dressing firmly (not too tight to avoid blocking circulation to fingers). Add a second bandage if leaks through first one.

Question 7

If object still in, what do you do ?

Answer 7

Clean with clean water. If large object, keep it in place. Apply pressure on either side to push wound edges together. If possible, raise and support wound. If possible, elevate feet. Cover wound and object with sterile dressing, building up padding around it until padding high than object. At that point bandage over the object.

Question 8

In fracture casualty, what are priorities ?

Answer 8

Preventing movement at site of injury and arranging removal to hospital with comfortable support.

Question 9

Which measures should be taken in fracture casualty ?

Answer 9

Apply arm sling (do not elevate).

Question 10

What is the definition of shock ?

Answer 10

Blood supply to tissues not sufficient

Question 11

What are the possible causes of shock ?

Answer 11

Septic shock (bacteria) Anaphylactic (allergy) Cardiogenic (heart damaged and so insufficient blood to rest of body) Hypovolaemic (due to severe blood and fluid loss) Neurogenic (due to spinal chord injury)

Question 12

What are the clinical sings and symptoms of shock?

Answer 12

Pale cold and clammy skin, quick pulse, quick breathing, fatigue, diluted pupiles, nausea

Question 13

What is the difference between open and closed fracture ?

Answer 13

Open has bone protruding from skin.

Question 14

What are the signs and symptoms of fractures ?

Answer 14

Swelling/bruising, loss of function, pain/deformity,

Question 15

What is normal capillary refill time ?

Answer 15

2 seconds or less

Question 16

What is meant by AMPLE history ?

Answer 16

Allergies
Medications
Past Illnesses/pregnancies 
Last meal/snack
Events/Environment related to injury

Question 17

What are examples of clues you might look for in the situation where the casualty was found ?

Answer 17

Witnesses, physical objects like surroundings objects etc.