Secondary Survey

As a Community First Responder and having completed a primary survey, quickly going through your DRAB, Danger,  Airway, Breathing;  and  addressed the immediate issues presented. There may be time prior to the arrival of ambulance back-up conduct a secondary survey.

As always, your own safety is vitally  important and ‘D’ for danger remains so ensure the scene is still safe and you are protected from blood and other bodily fluids.

Secondary survey comprises a head to toe examination of the patient.

Look for any signs or symptoms of injury or possible underlying medical conditions.

During the secondary survey gather as much information as possible, for instance the mechanism of injury, (what led up to the event).

When possible find out from the patient or bystanders if there are any underlying medical conditions which may relate to the episode.

This information can be extremely useful when you handover to crew.

Begin your secondary survey with the patient’s head.

Look for cuts, abrasions, swelling or discoloration.

Look for bleeding, specially in and around the mouth, nose and ears.

Look for any clear fluid weeping from these areas in particular the ears as this could be signs of spinal injury.

Check for discoloration behind the ears as it could be an indication of a severe head injury.

Moving down to the neck area.

Look for bruising, swelling, discoloration, cuts or abrasions.

Is there anything amiss such as a shifting of the windpipe,(tracheal deviation).

Look for any medical alert tags.

Use your first two fingers and find the carotid pulse. Count the beats for fifteen seconds and multiply by four to give you the heart rate.

Move on to the chest area

Look for any bruising, discoloration, cuts bruises or any penetrating wounds.

Monitor any abnormal rise and fall of the chest as the patient is breathing

Note any pain or tenderness that the patient may experience


Move on to is the abdomen.

Look for any injuries and pay close attention to pain, tenderness, discoloration, rigidity, guarding of painful areas

Look for any pulsating masses.

Move onto the arms.

Look for any signs of fracture, deformity, shortening or unusual rotation.

Check their pulses at the wrist. If you cannot find a pulse inform the crew.
Look for medical alert bracelet.


Move to the legs.

Look for any fractures, deformity or shortening.
Check the top of the foot for the pedal pulse.

If there is no immediate indication of trauma or any spinal injury, gently roll the patient onto their side and quickly do a survey of their back.

While doing your secondary survey, note as much information as possible such as the level of the patient’s consciousness. If the patient is alert and oriented to time and place.

Note if they confused or even unconscious.

Do they know what happened or what started the event?

If possible, ask about any medical problems,  medications, allergies etc.