Secondary survey

• Follows primary survey and resuscitation
• Involves head to toe systematic assessment
• May include re-assessment of primary survey
• May include additional imaging & blood tests

Secondary survey - examination includes:

• Head
• Face
• Cervical spine and neck
• Chest
• Abdomen : Are clinical signs reliable?
• Limbs
• Perineum

Secondary survey - examination includes:

• Back
• Fractures
• Neurological examination including GCS
• PR examination

Long bony injuries/Pelvic injury

• Issues include:
Massive blood loss
Long surgical procedures with other serious injuries (eg head injury)
Surgical procedures need to be performed in order of importance

Intra-theatre problems

• Handover
• Multiple doctors
• Documentation
• Personal protection
• Procedures
• Patient access
• Vascular
• Surgical access