Secondary Survey

Secondary survey

Head -to-toe survey

If the casualty is breathing normally a secondary survey should be carried out. Inform the casualty what you are doing at all stages. If the casualty is responsive ask them to tell you if they feel any pain during the head – to – survey.

Head and face

Look at the casualty’s head and face for any obvious signs of injury or trauma. Remove spectacles if the casualty is wearing them. Gently feel around the head, face and scalp for any bleeding, swelling or depressions. Look at the casualty’s ears for signs of bleeding or the presence of Cerebrospinal fluid(CSF).


Loosen any restrictive clothing such as ties or collars. Gently feel around the cervical spine area and back of the neck to check for any bleeding, swelling or deformity and also check for medical necklaces.

Chest and shoulders

Gently feel around the shoulders to check for signs of deformity and bleeding. Check the chest for normal breathing movement (rise and fall) and check for any bleeding.

Arms and hands

Check along the arms, feel for signs of deformity, swelling and bleeding. Check the wrists for medical bracelets


Try to check as much of the spine as possible without moving the casualty; feel for tenderness and deformity as well as signs of bleeding.


Check the hips and pelvis for deformity, unnatural positioning or bleeding.


Gently check the abdomen for signs of bleeding, swelling or unnatural softness.

Legs and feet

Check the legs and feet for bleeding, unnatural positioning, swelling and deformity. Check the pockets of skirts or trousers for objects that may cause discomfort or pain should the casualty be moved.