Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual
ABCDE of trauma
Airway management
Airway management techniques
Ventilation (breathing) management
Circulatory management
Circulatory resuscitation measures
Secondary surgery
Chest trauma
Abdominal trauma
Head trauma
Spinal trauma
Neurological trauma
Limb trauma
Special trauma cases
Transport of critically ill patients
Trauma response
Activation plan for trauma team
Primary Trauma Care Manual | Secondary surgery
 

 

Undertake the secondary survey only when the patient’s ABCs are stable.

If any deterioration occurs during this phase, it must be interrupted by another primary survey. Documentation is required for all procedures undertaken.

Undertake a head-to-toe examination, noting particularly the following.

HEAD EXAMINATION

:: Scalp and ocular abnormalities
:: External ear and tympanic membrane
:: Periorbital soft tissue injuries.

NECK EXAMINATION

:: Penetrating wounds
:: Subcutaneous emphysema
:: Tracheal deviation
:: Neck vein appearance.

NEUROLOGICAL EXAMINATION

:: Brain function assessment: use the Glasgow Coma Scale (page PTCM–23)
:: Spinal cord motor activity
:: Sensation and reflex.

CHEST EXAMINATION

:: Clavicles and all ribs
:: Breath sounds and heart tones
:: ECG monitoring (if available).

ABDOMINAL EXAMINATION


Suspect cervical spine injury in head injury patients until proven

PELVIS AND LIMBS

:: Fractures
:: Peripheral pulses
:: Cuts, bruises and other minor injuries.

X-RAYS (if possible and where indicated)

:: Chest, lateral neck and pelvis X-rays may be needed during primary survey
:: Cervical spine films (it is important to see all 7 vertebrae)
:: Pelvic and long bone X-rays
:: Skull X-rays may be useful to search for fractures when head injury is present without focal neurological deficit, but are seldom indicated.





Top of Page