The secondary survey assesses the injuries of an awake, responsive person. It involves thoroughly examining the person’s health history, assessing the four vital signs and conducting a systematic head-to-toe examination. If we discover any injuries, we administer first aid accordingly. Finally, we document all our actions and findings of the entire process. A secondary survey is performed after completing the primary steps of first aid (remembered as DRABC).
| Primary Survey | Secondary Survey |
| First examination | Second examination |
| Assesses and stabilities a person in life threatening conditions | Diagnoses and treats major injuries after stabilisation  |
| Follows DRABC steps | Follow AMPLE steps |
| Does not involves a head to toe examination | Involves a head to toe examination |
| For responsive or unresponsive patients | Typically for responsive patients |
In a secondary survey, we look for injuries. We physically examine every part of the injured person’s body from head to toe. We check the front, back, sides, underneath, and top. This survey includes looking at the airway again and checking the lungs again.
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Ask questions to learn more about the person’s medical background.
Remember the word “SAMPLE” to help you remember what to ask:
S stands for Symptoms: What the person feels, like pain or weakness.
A stands for Allergy: Do they have any allergies? These could be to nuts or medicines like penicillin or aspirin.
M is for Medication: Are they taking any medicines?
P is for Previous medical history: Do they have any ongoing health conditions like diabetes or epilepsy? Have they had any surgeries or injuries before?
L is for Last Meal: When did they last eat or drink?
E is for Event history: What happened, and where did it happen? Was it because of an illness or an accident? Talk to anyone nearby to find out more, and look for any clues that could help understand what happened. Also, check if they have any special jewellery that might have medical information on it.
Check four critical things:
Level of Consciousness: Are they awake and aware?
Breathing: Are they breathing normally?
Pulse: What’s their heartbeat like?
Skin Condition and Temperature: Is their skin normal, and are they warm enough?
By conducting this secondary survey, we ensure that we’ve covered everything and helped the person in the best possible way.
Checking someone’s level of consciousness (LOC) helps us understand how aware they are. We often use the letters AVPU to do this:
Remember, another quick way to check is to look at their eyes, listen to what they say, and see if they can follow simple commands like squeezing your fingers.
To check someone’s breathing, watch their chest rise and fall for 30 seconds. You can also gently place your hand on their stomach to feel it. Count how many breaths they take in that time, and then double it to know how many breaths they take per minute. Here’s what’s expected:
Normal Breathing Rated (no. of breaths) | |
Infant | 30-50 |
Child | 20-30 |
Adult | 10-20 |
Your pulse shows how often your heart beats in a minute. You can check it by feeling the person’s wrist, neck, or upper arm. Use two fingers and press gently until you feel the pulse. Count how many beats you feel in 30 seconds, then double it to get the beats per minute.
Normal Pulse Rates:
Normal Pulse Rates (beats/min) | |
Infant | 120-150 |
Child | 80-50 |
Adult | 60-100 |
When we check someone’s skin, we’re looking at a few things:
To check, gently feel their forehead and cheeks with your hand. If their skin is normal, it should feel warm and dry and be a regular colour. But if it’s pale, cold, and sweaty, it could mean they’re going into shock.
This is a thorough check of the person’s whole body for any injuries we might have missed earlier. Here’s how to do it:
Let’s start at the head:
Now, let’s move to the neck:
Now, onto the arms:
Next, let’s look at the chest and underneath:
Let’s check the tummy and underneath:
Now, let’s look at the hips:
Moving down to the legs, ankles, and feet:
Once you’ve finished checking everything, it’s time to give the right first aid for any injuries or illnesses you find. If the person has more than one injury, start with the most serious one.
After you’ve given first aid, write down what you’ve found and what you’ve done. This information can help doctors or other medical staff who will care for the person later. It is important to know if the injury happened at work because it might need an investigation. You’ll usually fill out forms provided for this purpose, and you should keep them as required by the rules in your area.
The Emergency First Aid training course is designed for low-risk environments such as offices and small retail stores. It gives participants the fundamental knowledge and skills to manage emergencies in these settings effectively.
On the other hand, First Aid Training at Work is one of the extensive first aid courses that meets the requirements specified in the Health and Safety Regulations (First Aid) 1981 and goes a step beyond the Emergency First Aid at Work (EFAW) course, qualifying you to work in high-risk workplaces.
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What are the four vital signs for a secondary survey?
The four vital signs of a secondary survey are checking the level of consciousness (LOC), breathing rate, pulse rate, skin condition and temperature.
What does SAMPLE stand for in a secondary survey?
SAMPLE stands for Symptom, Allergy, Medication, Previous medical record, Last meal and Events leading to the casualty. It is the order in which the history of the injured person is taken.
What is the main aim of the secondary survey?
The main aim of the secondary survey is to check for major injuries that might have been missed during the primary survey.
What are the steps included in Emergency Scene Management?
The steps included in ESM include scene survey, primary survey, secondary survey and ongoing casualty care.
