Trauma Secondary Survey

Excerpt

Rendering care to a trauma patient can be a challenging endeavor due to the potential for numerous injuries. This part of evaluation should not be performed until the primary survey is completed. However, in patients with multi-system trauma, evaluation and management can often occur simultaneously. Therefore, secondary survey occurs both in series and in parallel with the primary survey. This evaluation ensures that all potentially life-threatening conditions have been identified and satisfactorily addressed. Not all injuries are immediately apparent in trauma patients. Occult injuries may be missed and delayed diagnosis can contribute to morbidity and mortality. The secondary survey is a rapid but thorough head-to-toe examination assessment to identify all potentially significant injuries. It is helpful to set the priorities for continued evaluation and management. It should be performed after the primary survey, and initial stabilization is complete. The purpose of the secondary survey is to obtain pertinent historical data about the patient and his or her injury, as well as to evaluate and treat all significant injuries not found during the primary survey by performing a systematic, complete examination. Since trauma is a dynamic process, frequent reassessment is required in patients with trauma. If deterioration of clinical status is noted, primary survey should be repeated and evaluation of ABCs should be started. This will identify conditions, that require immediate intervention.