Tertiary Survey

• 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.

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

• 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

• 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.