Coupon Accepted Successfully!


Secondary Survey

  1. Total Evaluation of Patient
    Is patient ABC Stable? If yes, then go head to toe, front to back, over the whole patient looking for injuries/complications etc. Constantly reassess ABC's
    1. Head and skull (including ears and oral cavity)
    2. Maxillofacial injuries
    3. Neck
    4. Chest
    5. Abdomen
    6. Perineum/Rectum
    7. Extremities
    8. Complete neurological examination
    9. Appropriate x-rays, laboratory tests, and special studies
    10. "Tubes and fingers" in every orifice ie PV / PR.
  2. Monitor
    1. ECG
    2. BP
    3. O2 saturation
    4. Core temperature
  3. Insert
    1. Urinary catheter
    2. Gastric tube (Oro-gastric NOT Naso-gastric if head / facial injuries)
  4. ​X-Rays
    1. Cervical spine lateral initially and ensure C7 and Tl are visualised.
    2. Erect CXR
    3. Pelvis
  5. ​Blood
    1. ABG - Remember acidosis is a sensitve indicator of the effectiveness of resuscitation. Repeat frequently.
    2. X match
    3. FBC
    4. UEC, LFT, AMY
    5. Blood Glucose
  6. Head Trauma Q 
    1. TBI may be divided into 2 broad categories, closed head injury and penetrating head injury.
    2. The Glasgow Coma Score (GCS) is used to describe the level of consciousness of TBI patients.
    3. The GCS is divided into 3 categories, eye opening (E., motor response (M), and verbal response (V).
    4. The score is determined by the sum of the score in each of the 3 categories, with a maximum score of 15 and a minimum score of 3, as follows:
Score Motor Verbal Eye Opening
6 Obeys commands N/A N/A
5 Localizes stimulus Oriented N/A
4 Withdraws from stimulus Confused Spontaneously
3 Flexes arm Words/phrases To voice
2 Extends arm Makes sounds To pain
1 No response No response Remain closed
GCS = E + M + V: E + M + V = 3 to 15
Generally, the GCS:
  1. For severe head injury is 9 or less; 
  2. for moderate injury, 9-12; and
  3. for minor injury, 12 and higher.
In a patient with head injury, eye opening is seen with painful stimulus, there is appropriate verbal response to pain, and patient can localize the pain. What would be his GLASGOW COMA SCALE (GCS) score? (AIPG 2011)
  1. 8
  2. 10
  3. 12
  4. 14
Ans. B. 10.

Test Your Skills Now!
Take a Quiz now
Reviewer Name