Which item is not typically part of a secondary survey?

• A. Immediate imaging in the field.
• B. Head-to-toe examination.
• C. Vital signs.
• D. Neurological status.

Answer: (A)

In the secondary survey, after life-threatening issues are addressed in the primary survey, the focus is a structured, comprehensive assessment to find remaining injuries. This includes a detailed head-to-toe physical examination, obtaining a history, and ongoing monitoring of vital signs and neurological status to catch problems that aren’t immediately obvious and to track any changes.

Imaging in the field isn’t a standard part of this step. Imaging requires equipment, time, and often a controlled environment, and the priority during the secondary survey is to complete a thorough clinical assessment and stabilize the patient if needed. Decisions about imaging are typically made after initial stabilization, in a hospital setting, guided by the findings from the secondary survey.

That’s why the other elements—head-to-toe examination, vital signs, and neurological status—are integral to the secondary survey, while immediate field imaging is not.