Tertiary Survey for Trauma Inpatients

These guidelines outlines the process of the completing the tertiary survey on trauma inpatients and who, how and when this should be completed.

Definitions

Tertiary Survey refers to the comprehensive general physical re-examination and review of all investigations, including diagnostic imaging and blood results, within 24 hrs and again when the patient is conscious and cooperative (Hajibandeh et al, 2015)

Missed injury detection are those that are not identified by primary or secondary surveys but are detected by tertiary survey (Hajibandeh et al, 2015).

Overview/Background

Missed injuries are considered an important issue in trauma patients and can lead to significant mortality and morbidity. The reported incidence of missed injuries is variable ranging from 1% to 40%. Risk factors for missed injuries include:

Altered level of consciousness such as:

• Central nervous system injury
• Intoxication and sedation
• A distracting injury
• Poly trauma patients
• Patients needing emergency surgery

The tertiary survey is widely used in the reassessment of trauma patients, reducing any missed injuries that may be overlooked at the initial time of presentation. The best available evidence demonstrates support in favour of tertiary survey in terms of missed injury reduction, and supports its use in management of trauma patients (Hajibandeh et al, 2015).