How to Conduct a Secondary Survey of the Chest and Abdomen During First Aid 

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Overview 

Conducting a primary or a secondary survey of the chest and abdomen during first aid is done during the patient assessment phase of the emergency operations incident. The patient assessment phase is the methodological procedure used to figure out what is wrong with the victim or patient. They are done systematically so that every time, every patient is treated in the exact same manner so that it is completely routine and nothing is overlooked. Because of this systematic approach, learning to conduct a secondary survey of the chest and abdomen during first aid is a very simple, yet vital task.

Steps

1. Know the steps in the primary survey

This is the initial patient assessment that is done right after the scene size-up. This is your initial thoughts and decision making period as you roll up on the scene of the accident or incident. The basic steps are easy to remember if you consider them your basics.

• Airway: The first and most vital thing you need to do is make sure that the victim has an open airway. Whether breathing on his own, or with assistance, oxygen is vitally important as without it, nothing else matters. The victim will die without an open airway.
• Breathing: After an open airway is secured, make sure the victim is breathing. If not, you will need to start breathing for her.
• Circulation: If there is no circulation, you must start CPR.
• Disability: Check the patient's alertness. Check the head, neck and spinal areas. Check for distal pulse and the ability for the patient to move his extremities.
• Expose: Being ever so mindful of the patient's privacy, remove clothing where injuries are suspected. You cannot assess a patient in places that you cannot actually see.

2. Start the secondary assessment or survey after the patient has been secured or stabilized

If the patient is conscious and alert, you will need to get his consent before examining him and be sure to communicate exactly what you are doing and why.

3. Begin at the head and end at the toe

The secondary assessment is just as systematic as the primary assessment. When you get to the chest, you will want to check for bruising or unusual coloration, lumps, puncture wounds or flailing of the chest. Listen for abnormal breathing sounds from front to back and all 4 quadrants. You are also listening for equal breathing from both lungs.

4. Carefully check for fractures of the chest

Warn the patient that this might be extremely painful if fractures are present.

5. Inspect the abdomen visually for obvious trauma, wounds or injuries such as burns, distension or an avulsion with organs protruding

6. Feel the abdomen for tenderness where there are not obvious wounds present

If there is pain, the patient will react immediately by trying to cover up the area with his hands or arms.

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