Secondary assessment Head to toe

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Secondary assessment
Secondary assessment purpose (2)
First you will not be taken by surprise bynsomething you overlooked

Second you may discover hidden more serious injuries
Secondary assessment parts (4)
Vital signs

A head to toe exam

Patient history

Documentation
Head
Battle signs
Raccoon eyes
Vital signs measure and record (8)
Measure and record

Breathing rate

Pulse rate

Blood pressure

LOC

pupil reaction

Skin condition

Pain tolerance
Breathing rate
Depth and regularity
Pulse
Strength an rythym
Blood pressure
Cuff or
Radial 80
Femoral 70
Carotid 60
LOC
Alert
Verbal
Pain
Unresponsive
Skin condition
Temperature colour moisture
Pain
Scale 0-10
Vitals importance
To establish a baseline

Record time

Findings in primary assessment

Patients full name
Pulse observations
Strength and rhythm radial then carotid
15 seconds times by 4
Note strength
Regular or irregular

Average adult 60 - 100 bpm
Pulse possible conditions rates
None = cardiac arrest
Slow under 60 = cold injury , heart attack, heat injury
Fast above 100 = shock , heart attack, heat injury
Pulse strength and conditions
Weak = shock heart attack cold injury overdose
Strong = normal
Bounding = heat injury, overdose, heart attack
Pulse rhythm and conditions
Irregular = heart attack
Regular = normal
Blood pressure
The pressure that circulating blood exerts against the walls of the arteries systolic over diastolic
Systolic
Level of pressure during contraction of the heart when blood is pumped through the arteries
Diastolic
Pressure in the vessels during relaxation of the heart on return to heart
Pulse rate to blood pressure ares
Radial 80
Femoral 70
Carotid 60
Measuring blood pressure with sphygmomanometer (blood pressure cuff and stethoscope
Secure cuff on upper arm over brachial artery
Inflate cuff until 20 points above where needle stops
Place stethoscope over diaphragm of brachial pulse
Release air slowly
The first sound of pulse on dial is systolic pressure
Pulse sounds disappear on dial is diastolic pressure
Breathing rate respiration's observe
Rate
Depth
Effort
Breathing rate calculations
Count number of breaths chest expansions in 15 seconds times by 4
Normal adult 16-20
Breathing rate possible causes
None = cardiac arrest

Slow below 10 = stroke, head injury, overdose, chest injury
Fast above 20 = asthma! shortness of breath, chest injury! shock
Patterned = head injury diabetic coma
Recheck neck
Clavicle
Scapulas
Repeat primary
Recheck
Upper extremities
P
M
S
Lower extremities
Stages in assesment (4)
Scene survey

Primary Assesment

Transportation decision

Secondary assessment
Stages of treatment image
Secondary assessment
Establish baseline vital signs and throughly reassess patient for all injuries
Pelvis exam
Abdomen exam
Chest exam
Neck exam
Finding injuries look and feel
Evaluation neck to knee