Rapid Trauma Secondary Assessment

What are the different sections of the rapid trauma secondary assessment?

• head/face

• neck

• chest

• back

• abdomen + pelvis

• legs (then arms)

What are the standard components of CLAPS-D?

• contusions

• contaminations

• lacerations

• abrasions

• penetrations

• punctures

• protrusions

• swelling

• deformities

• dried blood

• diaphoresis

What are the standard components of TICS-D?

• tenderness

• instability

• crepitus

• swelling

• deformities

True or false: subcutaneous emphysema should be checked in each section of the rapid secondary assessment

false → check in every section except abdomen + pelvis, and the extremities (legs, then arms)

What are you looking for during the head/face section of the rapid trauma secondary survey?

• contusions

• contaminations (blood, teeth, etc.)

• cyanosis

• lacerations

• abrasions

• penetrations

• punctures

• protrusions

• pupil reactivity + size accommodation

• swelling

• subcutaneous emphysema (SCE)

• deformities

• dried blood

• CSF from ears + nose

• diaphoresis

What are you feeling for during the head/face section of the rapid trauma secondary survey?

• tenderness

• instability

• crepitus

• swelling

• subcutaneous emphysema (SCE)

• deformities

What extra steps are required during the head/face section of the rapid trauma secondary survey?

check for pupil reactivity + size accommodation

What are you looking for during the neck section of the rapid trauma secondary survey?

• contusions

• contaminations

• lacerations

• abrasions

• penetrations

• punctures

• protrusions

• swelling

• subcutaneous emphysema (SCE)

• sucking wounds (open pneumothorax)

• deformities

• dried blood

• diaphoresis

What are you feeling for during the neck section of the rapid trauma secondary survey?

• tenderness

• instability

• crepitus

• swelling

• subcutaneous emphysema (SCE)

• deformities (step-off deformities of the vertebrae in particular)

What extra steps are required during the neck section of the rapid trauma secondary survey?

remove and re-apply c-collar as required to check for JVD (jugular venous distention) and tracheal deviation → want to know: pneumothorax? how far along is it? closed or open?

What are you looking for during the chest section of the rapid trauma secondary survey?

• contusions

• contaminations

• lacerations

• abrasions

• asymmetrical chest rise-and-fall

• penetrations

• punctures

• protrusions

• paradoxical chest segment (in self-ventilating patients)

• swelling

• subcutaneous emphysema (SCE)

• sucking wounds (open pneumothorax)

• deformities

• dried blood

• diaphoresis

What are you feeling for during the chest section of the rapid trauma secondary survey?

• tenderness

• instability

• crepitus

• swelling

• subcutaneous emphysema (SCE)

• deformities

What extra steps are required during the chest section of the rapid trauma secondary survey?

• auscultation of all 6 fields of the lungs

• palpate full length of clavicle, sternum, and ribs

What are you looking for during the back section of the rapid trauma secondary survey?

• contusions

• contaminations

• lacerations

• abrasions

• penetrations

• punctures

• protrusions

• swelling

• subcutaneous emphysema (SCE)

• sucking wounds (open pneumothorax)

• deformities

• dried blood

• diaphoresis

What are you feeling for during the back section of the rapid trauma secondary survey?

• tenderness

• instability

• crepitus

• swelling

• subcutaneous emphysema (SCE)

• deformities (step-off deformities of the vertebrae in particular)

What extra steps are required during the back section of the rapid trauma secondary survey?

perform a quarter roll to assess the back and perform a quick rake

What are you looking for during the abdomen + pelvis section of the rapid trauma secondary survey?

• contusions

• contaminations

• lacerations

• abrasions

• abdominal breathing (WOB assessment)

• penetrations

• punctures

• protrusions

• priapism (for male patients) + genital injuries

• swelling

• deformities

• dried blood

• diaphoresis

• distention (of the abdomen)

What are you feeling for during the abdomen + pelvis section of the rapid trauma secondary survey?

• tenderness

• instability

• crepitus

• swelling

• deformities

What extra steps are required during the abdomen + pelvis section of the rapid trauma secondary survey?

palpate all 4 quadrants of the abdomen (unless pelvic binder is on → do NOT re-palpate area, redundant)

What are you looking for during the extremities (legs, then arms) section of the rapid trauma secondary survey?

• contusions

• contaminations

• cyanosis

• lacerations

• abrasions

• penetrations

• punctures

• protrusions

• swelling

• deformities

• dried blood

• diaphoresis

What are you feeling for during the extremities (legs, then arms) section of the rapid trauma secondary survey?

• tenderness

• instability

• crepitus

• swelling

• deformities

What extra steps are required during the extremities (legs, then arms) section of the rapid trauma secondary survey?

• PMS check of extremities

• check for medical bracelets