Secondary Assessment
Table of Contents
Overview
A secondary assessment is done after DRSABCD and after immediate life threats have been managed. It helps identify injuries, illness clues, and changes that may not be obvious at first.
SAMPLE History
Ask simple questions if the casualty can respond. If they cannot, ask bystanders or look for medical alerts.
| Letter | Ask About |
|---|---|
| S | Signs and symptoms |
| A | Allergies |
| M | Medications |
| P | Past medical history |
| L | Last meal or drink |
| E | Events leading up to the problem |
Head-To-Toe Check
- Explain what you are doing and gain consent where possible.
- Look and gently feel for bleeding, swelling, pain, deformity, heat, or tenderness.
- Check the head, neck, chest, abdomen, pelvis, limbs, and back if safe to do so.
- Avoid unnecessary movement if spinal injury is suspected.
Vital Signs
Normal adult values vary, but useful approximate ranges are:
| Check | Approximate Adult Range |
|---|---|
| Temperature | Around 37°C |
| Respiratory rate | 12-20 breaths per minute |
| Heart rate | 60-100 beats per minute |
| Blood pressure | Around 120/80 mmHg |
| Oxygen saturation | 95-100% |
The radial pulse at the wrist is commonly used when checking circulation. Record findings, repeat them, and watch for trends such as rising pulse, worsening breathing, or falling responsiveness.