Major trauma tertiary survey

Why?

  • Around 1 in 17 major trauma patients have 'missed injuries' during their hospital stay which can cause significant morbidity.
  • Trauma tertiary surveys may reduce this figure to as low as 1 in 40.
  • The Intensive Care Society and trauma quality improvement programs have therefore made it a quality standard.

Who?

All trauma patients admitted to critical care.

What?

A comprehensive general physical re-examination and review of all investigations, including imaging and blood results.

When?

  • Within 24 hours of admission 'after the dust has settled'.
  • Repeated once awake, if reduced level of consciousness. 

What is the difference between a primary and secondary survey?

  • Primary survey = usually performed by the trauma team.
  • Secondary survey = completed by an appropriately trained provider who can complete a head to toe examination 

The secondary survey  may still need to be completed when patients arrive in Critical Care.

The tertiary survey should be performed at a later stage (within 24  hours) when more information may be available and initial procedures/operations are complete.  This can be undertaken by ICU staff or the major trauma team

How?

  • On admission fill in all trauma patients on whiteboard as we do for APACHE forms.

  • Perform the survey and document in trak using the shortcode "\majortraumatertiarysurvey" 

  • Wipe off whiteboard once TTS completed.

Editorial Information

Last reviewed: 01/09/2021

Next review date: 01/09/2024

Version: 1.0