The secondary survey is performed as soon as time permits and once the patient has been resuscitated and primary survey issues stabilised. It involves a more thorough head-to-toe examination, and the aim is to detect any injuries that were not detected or managed during the initial assessment and resuscitation. If during the examination or at any time a deterioration is detected, go back and reassess the primary survey using the ABCDE systematic approach. Consider further diagnostic imaging if available and indicated.
Taking an adequate history from the patient, bystanders or emergency personnel related to the events surrounding the injury can assist with understanding the likely extent of the injury and any potential for other injuries.
Use the AMPLE acronym to assist with gathering pertinent information:
Past medical history including tetanus status L Last meal E Events leading to Injury
As with all trauma patients a head-to-toe examination is imperative to ensure all injuries are identified and subsequently managed. During this examination, any injuries detected should be accurately documented and any required management should commence concurrently. Management priorities should be ordered, and tasks should be appropriately delegated to ensure efficient and effective care.
For further detail please refer to the Secondary Survey of the Early Trauma Care guideline.