What is the essential content of a secondary survey when assessing an athlete with multiple injuries?

• A. Head-to-toe examination, vital signs, neurological status, tenderness, deformities, and function.
• B. Only check vital signs.
• C. Focus only on most painful injury.
• D. Imaging first, then treat.

Answer: (A)

In the secondary survey, the goal is to identify all injuries beyond any immediately life-threatening conditions. This requires a thorough head-to-toe examination along with ongoing checks of vital signs and neurological status to catch any deterioration. You assess for tenderness and deformities across the body, look for signs of swelling or instability, and test function by asking the athlete to move limbs, feel sensations, and perform simple tasks. Checking distal circulation in the limbs—pulses, capillary refill, and temperature—helps ensure there isn’t hidden vascular compromise. It’s important to include an overall neurological assessment (clarifying orientation, memory, and motor/sensory function) and, where indicated, consider spinal precautions. The results guide where to image and how to treat or immobilize injuries, ensuring no injuries are overlooked and that transport decisions are appropriate. Focusing only on vitals or on the most painful injury would miss other problems, and imaging is used to investigate suspected injuries rather than replace a comprehensive exam.