Exposure

No primary survey is complete without thoroughly disrobing the patient and examining the total body surface area carefully for bruises, lacerations, impaled foreign bodies, and open fractures. If hemodynamically stable and if the airway is ensured, the patient should be logrolled, with one attendant assigned to maintain cervical stabilization. Check the back, and thoracic and lumbar spine for tenderness. Check the gluteal cleft and perineum for injury. When the exam is completed, the patient should be covered with warm blankets to prevent hypothermia.

When derangements in any of the components of the primary survey are identified, treatment is undertaken immediately. Once the primary survey is complete, securing of the airway, intravenous catheters as well as urinary and gastric catheters, and monitors should be achieved. At this point a secondary survey, a more thorough head-to-toe evaluation, is undertaken. It should be stressed that the secondary survey is not initiated until the primary survey (ABCs) is assessed to be adequate and resuscitation has been initiated.

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