How to perform a head to toe assessment
Performing a thorough head to toe assessment (sometimes called a ‘body check’) is an important step in the secondary survey.
Systematically searching the patient, region by region, first aiders should make a note of all injuries, starting at the head and proceeding through the neck, chest and abdomen to the extremities.
- lacerations and bruising
- blood or cerebrospinal fluid from the ears or nose
- re-check pupil size and response
- pallor and sweating
- scalp hematomas (swellings)
- depressed skull fractures
- facial tenderness and fractures
- airway noise suggesting obstruction
- breathing adequacy and rate
Look and feel for:
- lacerations and contusions
- surgical emphysema
- spinal deformity, tenderness or hematoma
- re-check pulse rate and strength
- wounds and evidence of penetrating injury
- deformity and abnormal movements
- breathing distress and pain on breathing
- instability of a flail segment (multiple rib fractures)
- surgical emphysema (air under the skin)
- penetrating wounds and contusions
- seat-belt contusions and clothing imprints
- tenderness, either localised or generalised
- guarding − involuntary muscle spasm on gentle palpation.
- obvious wounds and contusions
- deformity and swelling associated with fractures
- voluntary movement
- tenderness and deformity
- distal pulses
- intact nerve supply – sensation to touch and pain, motor function
- normal movements in joints.