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A secondary survey is a head to toe exam of a patient who has an open airway, is breathing at least once every 5 seconds (12 breaths per minute), but is unconscious and showing signs of shock. This is done after EMS has been alerted. The proper position for a secondary survey is the same as rescue breathing, chest compressions, or using an AED. You extend the patient's arm out from their body if possible, then straddle, but do not sit on, that arm.

To begin the exam, if there is no suspected neck injury, tilt back the patient's head and make sure his airway is open. Carefully feel the skull for soft spots or fracture points, then check your gloves for blood. Check the face and back of the neck, then go down one side and check the arm for fractures, deformities, or bleeding. After inspecting the other arm, press lightly on each side of the chest. Next press softly on all 4 quadrants of the abdomen. Check one leg and then the other for fractures or bleeding. When this is completed, inform EMS of your findings. While waiting for EMS you must continue to support airway, breathing, and circulation. You can then begin treating any bleeding and do shock management.