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

Question

Accepted Answer

B. Detailed head-to-toe physical examination and history. ## 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]

Answer

A. Breathing adequacy and ventilation status

Answer

C. Presence of shock and hemorrhage control

Answer

D. Airway patency and cervical spine protection

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

Explanation

Primary vs. Secondary Survey

Timing and Purpose

Components of Secondary Survey

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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