A head to toe survey is an evaluation of the trauma patient. In this evaluation, the "look, listen and feel" approach is used to evaluate the skin and everything it contains.

There is an ordered approach to this survey as with ABC's so it can be rapidly performed to minimize time at the scene. This is done region by region beginning at the head and proceeding through the neck, chest and abdomen to the upper and lower extremities. It is important not to miss anything when treating a casualty.

To ensure that you absorb all the information available, irrespective of your internal turmoil and near panic, it is important that you approach the incident in a confident and methodical way.

Assessment of the head (remember to have on disposable gloves to protect yourself at all times!)

Look for - 1- Lacerations
2 - Bruising
3 - Blood or cerebrospinal fluid (straw coloured) from ears or nose (this suggests a basal skull fracture)
4 - Check that pupils are of equal size and are reacting to light
5 - Bruising around eyes and behind ears (known as Raccoon eyes and Battles sign)
6 - Sweating
7 - Cyanosis (blue lips, earlobes with grey ashen face - indicating poor oxygen perfusion)

Feel for- 1 - Bleeding from scalp 2 - Depressed areas of the skull 3 - Facial tenderness and fractures

Listen for- 1 - Airway 'noise' suggesting obstruction 2 - Breathing depth and rate - average adult should be 16 - 20 per minute

Assessment of the Neck

Look and feel for- 1 - Lacerations and bruising 2 - Deviation of the windpipe 3 - Distension of the neck veins 4 - Check pulse rate and volume

Assessment of the Chest

Look for- 1 - Wounds and evidence of penetrating injury 2 - Deformity and abnormal movements 3 - Breathing distress and pain on breathing in

Feel for- 1 - Tenderness 2 - Instability and irregular movement - should be equal on both sides

Assessment of the Abdomen

Look for- 1 - Penetrating wounds and bruising 2 - Abdominal enlargement

Feel for- 1 - Tenderness 2 - Guarding - involuntary muscle spasm on gentle touch Assessment of the Pelvis

Feel for - (do not at any time spring or push the pelvis) 1 - Tenderness and instability Assessment of the lower and upper extremities

Look for- 1 - Obvious wounds and bruising 2 - Deformity and swelling associated with fractures (to be covered in later session) 3 - Voluntary movement

Feel for- 1 - Tenderness and deformity 2 - Sensation to touch and pain

On completion of the head to toe survey, immediately stabilise any located injuries, for instance by the application of a splint to a fracture. (Fractures to be covered in next newsletter)

THE TRAUMA PATIENT MUST BE REASSESSED FOR ANY DETERIORATION!!

These First Aid articles are designed to improve the knowledge of all who read them, keep them in a safe place, you never know when you may need them!

**Standard Disclaimer**:-The information provided above should not be used to take the place of a licensed physician or suggest that any person use the information as a sole resource for diagnostic or educational purposes. Rigg Access does not warrant that the information is in every respect accurate or complete and they are not responsible for any errors or omissions or for the results obtained from the use of such information