How to Conduct a Secondary Survey of the Head During First Aid

One of the most frequent causes of death in the wilderness is injuries to the head, including scalp, brain and skull injuries. Carefully examine the head to assess whether to immediately evacuate the injured person and whether to treat for brain injuries.

Instructions

Difficulty: Easy

Things You’ll Need:

• Rubber Or Latex Gloves
• Surgical Masks

1. Put on rubber gloves and a surgical mask before touching the injured person.
2. Look at the injured person's head and face and note any abrasions, bruising, open wounds, discoloration or bleeding. Pay special attention to the area of the skull behind the ear, because bruising often occurs here as a result of brain injuries.
3. Look in the injured person's nose and ears for any blood or clear fluid.
4. Look at the injured person's facial bones for any asymmetry or deformities. These may be especially apparent when you look at the cheekbones.
5. Feel the injured person's head lightly for any swelling, depressions, tenderness or pain.
6. Check the eyes for any asymmetry of the pupils or problems with vision. (See "How to Check Vital Signs.")

Tips & Warnings

• A thorough exam will include the following combination of actions: look, listen, feel and smell.
• If an injured person is unconscious, watch his or her face during the examination and note whether anything appears to be causing pain.
• Infectious diseases such as HIV and hepatitis are transmitted via the exchange of bodily fluids. Protect yourself by wearing gloves and a surgical mask. Wear goggles or glasses to protect from spurting blood or fluids.
• An injured person should always be evacuated from the backcountry if he or she loses consciousness at any point, regardless of whether any other signs or symptoms are present.
• Bruising, open wounds, blackening of the eyes, blood or fluids in the nose or ears, swelling, depressions of the skull, asymmetry of the facial bones or pupils, and problems with vision are all indicators of serious injury and call for immediate evacuation and the assistance of medical professionals.
• If symptoms persist or if you have specific medical conditions or concerns, we recommend you contact a physician. This information is not intended as a substitute for professional medical advice or treatment.