Secondary Assessment steps

Secondary assessment (1)

Vital Signs: delegate if possible, then immediately proceed
a. HR: pulse rate/rhythm/quality (always)
b. RR: breathing rate/volume (always)
c. BP: auscultated preferred (always)
d. SpO2: if respiratory/cardiac/altered/sick
e. EtCO2: if respiratory/cardiac
f. D-stick: if altered/diabetic
g. Temperature: if sick/feverish

Secondary assessment (2)

History: consider patient/bystanders as source
a. SAMPLE and Pertinent Negatives
b. OPQRST as appropriate related to chief complaint
c. Additional relevant questions
i. MOI details
ii. NOI related questions

Secondary assessment (3)

Physical Exam: choose appropriate exams
a. Rapid Head-to-Toe:
i. If unresponsive or
ii. If serious MOI or
iii. If poor historian
b. Modified Focused (aka Complaint-Based):
i. If good historian (reliable patient) and
ii. No distracting injury
c. Detailed Head-to-Toe: en route to ED PRN (recommended on most patients)

Secondary assessment (4)

Field Impression and Treatments:
a. State field impression
b. Treatments and procedures appropriate to field impression
c. Med requires dose/route and check for contraindications
d. Find it → fix it: treat all conditions found