b'The Secondary SurveyChapterAfter the Primary Survey (DRSABCD) has been checked, any bleeding controlled and the patient is stabilised, further assessment may be needed in order to identify other possible injuries. A check over or examination of the patient is necessary, particularly if the patient is unconscious or traumatised.For a conscious patient look for signs and ask for symptoms.For an unconscious patient examination is restricted to signs only.This examination is known as the Secondary Survey.The highest priority is to keep the patient alive.Everything else is secondary.Start at the HeadCheck for any minor wounds, swelling, lumps and bumps, fractures.Check for any fluid discharge from the ears and nose.FaceRe-check airway and breathing. Check the eyes for abnormality, face for any swelling, fracturesor bruising.Neck, Shoulders, ChestAsk the patient to inhale deeply to see if it causes any discomfort.Discreetly check for minor wounds, swelling, fractures, pain and inflammation. Theremay be a medic-alert bracelet, which identifies an underlying medical illness such as an allergy, heart problems or a diabetic condition. This is particularly useful if the patient is unconscious.BackCheck for minor wounds, abnormalities, pain and tenderness. The patient may need to be gentlylog rolled(refer page 59) .Arms and LegsLook for any injury/deformity.Check for minor wounds, swelling, soft tissue injuries, fractures or abnormalities suchas unusual lumps and bumps.Abdomen, PelvisDiscreetly and gently check for distension, pain, tenderness, incontinence.An unconscious patient must be examined in the recovery position to ensure the airway is protected.88The Secondary Survey'