Which of the following is evaluated during the SECONDARY survey in trauma management?

Explanation

## Primary vs. Secondary Survey **Key Point:** The secondary survey is a **complete, systematic, head-to-toe physical examination** performed AFTER the primary survey is complete and life threats are stabilized. It is detailed and thorough, not emergent. ### Timing and Purpose | Aspect | Primary Survey | Secondary Survey | |--------|---|---| | **Timing** | Immediate (first minutes) | After primary survey stabilized | | **Focus** | Life-threatening injuries only | All injuries, head to toe | | **Approach** | ABCDE algorithm | Systematic regional examination | | **Urgency** | Emergent | Detailed and methodical | | **Includes history?** | Minimal (only immediate threats) | Full AMPLE history | ### Components of Secondary Survey **High-Yield:** The secondary survey includes: 1. **Detailed physical examination** — head, neck, chest, abdomen, pelvis, extremities, back 2. **AMPLE history** — **A**llergies, **M**edications, **P**ast medical history, **L**ast meal, **E**vents leading to injury 3. **Reassessment** of vital signs and response to initial interventions 4. **Imaging and investigations** — CT, X-rays, labs based on mechanism and examination findings **Clinical Pearl:** The secondary survey is performed in a **controlled environment** (resuscitation bay or ICU), never in the field or during active resuscitation. If the patient decompensates during the secondary survey, return immediately to the primary survey. **Mnemonic:** **AMPLE** = **A**llergies, **M**edications, **P**ast medical history, **L**ast meal, **E**vents/Environment. This is the trauma history component of the secondary survey. [cite:ATLS 10e]