The secondary survey or head-to-toe survey is a systematic way of checking a casualty for further injuries that may not always be apparent. When the casualty is an infant or a young child they may not be able to talk.
So as the title states we work from the head down to the toes:
Head and Face: Look at the infant or childs head and face for any obvious signs of injury or trauma, Remove spectacles if they are wearing any. Gently feel around the head, face and scalp for any bleeding, swelling or depressions.
Neck: Loosen any restrictive clothing. Gently feel around the cervical spine area and back of the neck to check for any bleeding, swelling or deformity. Also check for medical necklaces/bracelets.
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 of the chest) 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.
Spine: 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.
Pelvis: Check the hips and pelvis for deformity, unnatural positioning or bleeding.
Abdomen: 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 for objects such as toys that may cause discomfort or pain should the infant or child be moved.