The following steps outline how to complete a secondary assessment.
It is important to note that you should recommence a primary assessment any time during this procedure if the person becomes unresponsive to questioning or unconscious.
Secondary assessment steps include:
- make introductions—introduce yourself and ask the person their name
- gain consent to provide (and document) treatment
- ask and record how the person feels:
- are they experiencing any pain or discomfort
- where do they feel pain or discomfort
- how they would rate it from ‘none’ (0) to ‘worst pain or discomfort possible’ (10)
- are they feeling anxious, nauseous, dizzy, distressed, cold, short of breath or generally unwell
- ask the person questions while collecting information from them to inform treatment. Record details in an incident report form. You may use the mnemonic SAMPLE as a guide:
- S —signs (record what you see, smell and hear) and symptoms (ask and record how they feel)
- A —allergies
- M —medications
- P —past medical history
- L —last oral intake
- E —events leading up to the illness or injury
- Gain consent to touch—ask the person if you can gently perform a basic body check
- Complete a secondary survey (basic body check) with the person’s consent:
• Remain calm while continually informing the person what you are doing and ask their permission to do it before acting—ensure you still have their consent to proceed
• Use your senses:- look—for bleeding, deformity, penetrating objects, spontaneous movements, abnormal skin colour, abnormal breathing. Also, look for the person’s ability to open their eyes and wriggle their fingers and toes
- listen—for the person’s responses to questions and pain stimuli, and any signs of abnormal breathing
- feel—gently pat areas to feel for deformity, swelling, skin temperature and texture, and wetness that may suggest bleeding
- smell—to note any odours that may indicate other issues
- Sequentially examine the following body areas to check for signs of any additional injuries or illnesses:
- head, face and neck
- shoulders and front of chest, ribs, abdomen and pelvis
- front and back of limbs—upper then lower
- back (if possible)
- Prioritise the treatment of any additional injuries identified using the four Bs to help you:
i. breathing
ii. bleeding
iii. burns
iv. breaks - Provide treatment according to best practice guidelines
- Manage the person’s pain levels (see Pain management)
- Monitor and reassure the person (see Monitoring and reassuring a person)
- Document the details of the secondary and primary assessments in an incident report form as well as the treatment provided.
Note:
- Another member of your patrol team may ask the person questions and document details in an incident report while you complete a secondary survey.
- As a general rule in a multiple person situation, an unconscious person takes priority over other persons. However, you may need to make a decision in some extreme situations, such as mass rescues, about which person will most benefit from your assistance.
- Ask open questions, e.g., ‘How are you feeling?’. Do NOT pose leading questions, e.g., ‘Do you feel nauseous?’
- Be mindful of the person’s age, gender and culture and maintain their dignity when asking questions and providing treatment.
- Look to see if the person has a medical alert bracelet or necklace, or if there is any medication near the person.
- Move the person if they are in immediate danger, require extraction, need to be in a different position to maintain their airway or control severe bleeding, or to protect them from extreme weather conditions. This often takes teamwork and planning as moving a victim is a hazardous manual task.
- Pay careful attention to areas such as the groin and armpit where blood may be hidden.
- Record any time the person’s level of consciousness changes.