The goal of an injury check is to look carefully for injuries that were not identified during the primary assessment. An injury check may involve a focused examination or a hands-on check, depending on the comfort level of the person and whether the person is responsive.
If the person is responsive and able to answer questions, do a focused examination. Keep watching the person’s vital signs. If the person’s condition deteriorates, stop the examination and give first aid immediately.
To do a focused examination
- Explain that the purpose of the examination is to identify injuries.
- Ask the person if anything hurts or feels uncomfortable.
- If the person indicates an area of pain, discomfort, or concern, look at the area for signs of injury including discolouration (bruises) or deformities (odd shapes). For privacy reasons, do not remove any of the person’s clothing unless it makes providing first aid difficult.
- If there are no signs of any injury, ask focused questions about how the person feels. The symptoms the person describes might help to determine whether EMS/9-1-1 needs to be called and what kinds of care should be provided.
- If you find a medical identification product, be sure to read it carefully. It may indicate what is wrong, who to call for help, and what care to give.
- If the person doesn’t complain of any pain or tenderness, and there are no signs of injuries, ask the person to rest for a few minutes in a comfortable position. Check the quality of the person’s vital signs and ensure the ABCs are still unaffected. If there is no visible problem, help the person to stand up slowly when he or she is ready.
- Based on your findings, decide whether you need to call EMS/9-1-1, and provide first aid care as needed.
NOTE: If the person is responsive, you will usually be able to get the information you need from a focused exam and sample questions alone, but there may be situations where touching the person is necessary to assess an injury. If so, you may need to do a portion of the hands-on check, focusing on the injured area.
If a person is breathing but unresponsive, or is otherwise unable to communicate what is wrong, you may need to do a hands-on check to assess whether further first aid is required. Conducting a hands-on check involves systematically checking the person from head to toe for signs of injury. Look and feel for any abnormalities such as bumps, soft spots, deformity, bruising, and bleeding. You should also look at the ground around the person for signs of blood or other body fluids. Continue to watch the person’s ABCs and vital signs as you perform this check. If the person’s condition deteriorates, stop the hands-on check and give first aid immediately.
Begin by checking the head, then work downward, focusing on the chest, abdomen, and legs before checking the arms. This prioritizes the areas that are more prone to life-threatening bleeding and organ damage.
When checking the chest, feel the ribs for signs of deformity. If the person is unresponsive, watch the rib cage as the person breathes. Both sides should expand at the same time. If the person is responsive, ask him or her to take a deep breath (if it doesn’t cause any pain) to make it easier to check the expansion of the rib cage.
When checking the abdomen, press on it gently. It should be soft to the touch. If it feels hard or gentle pressure is painful, check carefully for bruising (some of the person’s clothes may need to be moved or removed at this point).
Pushing on a person’s injured pelvis can cause serious injury or worsen an existing condition, so this area should not be touched during the hands-on check.
Be careful not to reach underneath someone during a hands-on check because there could be glass or other objects that could hurt you.