1. Look at the face for obvious lacerations, bruises, and deformities.
2. Inspect the areas around the eyes and eyelids.
3. Examine the eyes for redness, and for contact licenses. Assess the pupils using a pen light.
4. Look behind the patients ears to assess for bruising (battle signs).
5. Use the penlight to look for drainage of spinal fluid or blood in the ears.
6. Look for bruising and lacerations about the head. Palpate for tenderness, depressions of the skull, and deformities.
7. Palpate the zygomatics for tenderness or instability.
8. Palpate the maxillae.
9. Check the nose for blood and drainage.
10. Palpate the mandible.
11. Assess the mouth and nose for cyanosis, foreign bodies (including loose teeth or dentures), bleeding, lacerations, and deformities.
12. Check for unusual odors on the patients breath.
13. Look at the neck for obvious lacerations, bruises and deformities. Observe jugular vein for distention.
14. Palpate the front and the back of the neck for tenderness and deformity.
15. Look at the chest for obvious signs of injury before you begin palpation. Be sure to watch the movement of the chest for respirations.
16. Gently Palpate over the ribs to elicit tenderess. Avoid pressing over obvious bruises and fractures.
17. Listen for breath sounds over the midaxillary and midclavicular lines.
18. Listen also at the bases and apices of the lungs.
19. Look at the abdomen and pelvis for obvious lacerations, bruises, and deformaties. Gently palpate the abdomen for tenderness. If the abdomen is unusually tense, you should describe the abdomen as rigid.
20. Gently compress the pelvis from the sides to assess for tenderness.
21. Gently press the iliac crests to elicit instability, tenderness, and or crepitus.
22. Inspect all four extremities for lacerations, bruises, swelling, deformaties, and Med Alert anklets or bracelets. Also assess distal pulses and motor and sensory function in all extremities.
23. Assess the back for tenderness and deformities. Remember if you suspect a spinal cord injury, use spinal precautions as you log roll the patient.