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    K.31 Secondary Survey

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    jamaliganteng88
    This document outlines the key components and process of a secondary trauma survey. It involves a full history and physical examination from head-to-toe, including evaluation of the head, neck, chest, abdomen, pelvis, extremities and neurological system. Special diagnostic tests may be used. The goals are to identify any injuries that were not found in the primary survey, monitor for deterioration, and determine the need for transfer to a higher level of care or specialist. Frequent reevaluation is important to prevent missed injuries or secondary complications.

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    © All Rights Reserved
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    K.31 Secondary Survey

    Uploaded by

    jamaliganteng88
    586 views26 pages
    This document outlines the key components and process of a secondary trauma survey. It involves a full history and physical examination from head-to-toe, including evaluation of the head, neck, chest, abdomen, pelvis, extremities and neurological system. Special diagnostic tests may be used. The goals are to identify any injuries that were not found in the primary survey, monitor for deterioration, and determine the need for transfer to a higher level of care or specialist. Frequent reevaluation is important to prevent missed injuries or secondary complications.

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    K.31 SECONDARY SURVEY.ppt

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    This document outlines the key components and process of a secondary trauma survey. It involves a full history and physical examination from head-to-toe, including evaluation of the head, neck, chest, abdomen, pelvis, extremities and neurological system. Special diagnostic tests may be used. The goals are to identify any injuries that were not found in the primary survey, monitor for deterioration, and determine the need for transfer to a higher level of care or specialist. Frequent reevaluation is important to prevent missed injuries or secondary complications.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    586 views26 pages

    K.31 Secondary Survey

    Uploaded by

    jamaliganteng88
    This document outlines the key components and process of a secondary trauma survey. It involves a full history and physical examination from head-to-toe, including evaluation of the head, neck, chest, abdomen, pelvis, extremities and neurological system. Special diagnostic tests may be used. The goals are to identify any injuries that were not found in the primary survey, monitor for deterioration, and determine the need for transfer to a higher level of care or specialist. Frequent reevaluation is important to prevent missed injuries or secondary complications.

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    SECONDARY SURVEY

    DEPARTEMENT OF
    ORTHOPAEDIC &
    TRAUMATOLOGY
    SURGERY

    Secondary Survey

    The complete

    history and
    physical
    examination

    Secondary Survey
    Key Components
    History
    Physical examination : Head-to-toe
    Tubes and finger in every orifice
    Complete neuro exam
    Special diagnostic tests
    Reevaluation

    Secondary Survey
    History
    A Allergies
    M Medications
    P Past Illnesses
    L Last meal
    E Events/Environment

    Secondary Survey
    Mechanisms of Injury

    Secondary Survey
    Head
    Complete neurologic examination
    GCS score determination
    Comprehensive eye/ear exam
    Pitfalls
    Unconscious patient
    Periorbital edema
    Occluded auditory canal

    Secondary Survey
    Maxillofacial
    Bony crepitus/stability
    Palpable deformity
    Pitfalls

    Potential airway obstruction


    Cribriform plate fracture
    Frequently missed injury

    Secondary Survey
    Cervical Spine
    Palpate for
    tenderness
    Complete motor/
    sensory exams
    Reflexes
    C-spine imaging

    Pitfalls

    Altered LOC for


    any reason
    Other severe ,
    painful injury

    Secondary Survey
    Neck (soft tissues)
    Mechanism : Blunt
    vs penetrating
    Symptoms : Airway
    obstruction ,
    hoarseness
    Findings :Crepitus
    hematoma ,stridor
    bruit

    Pitfalls
    Delayed
    symptoms
    and signs
    Progressive
    airway
    obstruction
    Occult injuries

    Secondary Survey
    Chest
    Inspect
    Palpate
    Percuss
    Auscultate
    X-ray

    Pitfalls
    Elderly
    Children

    Secondary Survey
    Abdominal Evaluation

    Blunt trauma
    trauma

    Penetrating

    Secondary Survey
    Abdomen
    Inspect, auscultate, palpate, and percuss
    Reevaluate frequently
    Special studies
    Pitfalls
    Hollow viscus and retroperitoneal injuries
    Excessive pelvic manipulation

    Secondary Survey
    Perineum

    Contusions, hematomas,
    lacerations, urethral blood

    Rectum

    Sphincter tone , high riding


    prostate pelvic fracture,
    rectal wall integrity, blood

    Vagina
    Pitfalls

    Blood lacerations

    Urethral injury in women,


    pregnancy

    Secondary Survey
    Musculoskeletal : Extreminities
    Contusion , deformity
    Pain
    Perfusion
    Peripheral neurovascular status
    X- rays as needed

    Secondary Survey
    Musculoskeletal : Pelvis
    Pain on palpation
    Symphysis width
    Leg length unequal
    Instability
    X-rays as needed

    Secondary Survey
    Musculoskeletal
    Pitfalls

    Potential blood loos


    Missed fractures
    Soft-tissue or ligamentous injury
    Occult compartement syndrome (especially
    with altered LOC / hypotension)

    Secondary Survey
    Neurologic
    Spine / Cord
    Complete motor
    and sensory exams
    Imaging as
    indicated
    Reflexes

    CNS
    Frequent
    reevaluation
    Prefent secondary
    brain injury

    Early neurosurgical
    consultation

    Adjuncts to Secondary Survey

    Special diagnostic test as indicated


    Pitfalls
    Patient deterioration
    Delay of transfer

    Secondary Survey
    Neurologic
    Pitfalls
    Incomplete immobilization
    Suble in ICP with manipulation
    Rapid deterioration

    Reevaluation
    Minimizing Missed Injuries
    High index of suspicion
    Frequent reeveluation and
    monitoring

    Reevaluation
    Pain Management
    Relief of pain /anxiety as
    appropriate
    Administer intravenously
    Careful monitoring is essential

    Definitive Care
    Local Facility
    ??
    Transfer agreements
    ?? Local resources ??
    ??
    Trauma
    Center

    Special
    Facility

    Record , Legal Considerations


    Concise, chronologic
    documentation
    Consent for treatment
    Forensic evidence

    Questions

    Summary
    Primary Survey
    Resuscitation
    Adjuncts
    Secondary Survey
    Adjuncts
    Definitive care

    THANK YOU

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