What is the recommended sequence for the secondary survey in wilderness medicine?

• A. Front-To-Back Examination With Quick Checks
• B. Head-To-Toe Examination (Head, Face, Eyes, Ears, Neck; Chest; Abdomen; Pelvis; Back; Extremities), Check for Wounds, Deformities, Tenderness, and Reassess Vital Signs and Symptoms; Obtain History
• C. Only Assess the Chest and Abdomen
• D. Back-To-Front Examination

Answer: (B)

In wilderness care, the secondary survey is a thorough, systematic check from head to toe to uncover injuries that aren’t immediately life‑threatening but still need attention. The best sequence starts at the head and moves downward: examine the head, face, eyes, and ears; assess the neck; evaluate the chest for signs of trauma and breathing status; palpate the abdomen for tenderness; assess the pelvis; inspect the back; and then examine the extremities for wounds, deformities, and tenderness while repeatedly reassessing vital signs and gathering history. This orderly approach helps you catch injuries that might be hidden by clothing or the patient’s position, keeps the exam comprehensive, and allows you to monitor how the patient’s condition changes as you document vitals and symptoms. Choosing a limited focus on the chest and abdomen or reversing the order can miss injuries and fail to provide a complete picture of the patient’s status.