How to Complete a Top to Toe Assessment of an Injury

Step-by-Step Guide

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   Step 1: First check the airway

   If they are not breathing or have no pulse, begin rescue breathing or CPR.
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   Step 2: breathing and circulation.

   Are they bleeding? Is there any dried blood? At this point, you should also be checking the face for any pain response. , Are they blood shot? ,"
   
   "can you hear me?" Continue by tapping on the shoulder, but be careful not to move the neck if a spinal injury is suspected. , Is the skin Patchy? does the temperature feel okay? Is the skin moist or clammy? Is there any swelling or disfigurement? Are there any pain responses? , If there is a sticky straw coloured fluid leaking, this may be a sign of spinal injury; DO NOT touch this fluid and DO NOT stop it from flowing. , This could be a sign of poor circulation, also called cyanosis.
   
   How does the breath smell? Could the casualty have consumed alcohol, or inhaled glue or another gas? If the breath smells of pear drops or acetone this could be a sign that the casualty is diabetic and in some form of shock. , Are there any cuts or swelling? Check firmness to touch.
   
   This could indicate internal bleeding.
   
   Check to make sure that the trachea is going down the middle of the neck.
   
   A windpipe that is off to the side could indicate air in the chest that is outside of the lung. ,, This could be trapped air, or internal bleeding. ,, Never skip this part when necessary just because of invading patient privacy, but then again respect the patient's privacy as much as possible. , Is there any swelling? Any cuts or contusions (bruises)? Try to find a pulse in the foot(just around the top where the foot meets the ankle); is there a presence or absence of a pulse? , If it takes more than two seconds for the nailbeds to return to their original color, this could be a sign of poor circulation.
   
   Check for a pulse in the wrist; is there a presence or absence of a pulse?
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   Step 3: Starting at the head

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   Step 4: look and feel for any lumps or bumps

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   Step 5: being careful not to move the injured person/ change position of spine.

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   Step 6: Check the eyes for dilation (this may indicate any brain damage incurred).

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   Step 7: Check for their level of consciousness by asking

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   Step 8: "are you alright?

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   Step 9: Checking the face: is the colour abnormal?

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    Step 10: Checking the ears: Check for injury and then look inside the ears.

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    Step 11: Checking the mouth: Are the lips blue?

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    Step 12: Checking the neck: Feel for bulging.

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    Step 13: Checking the Ribcage: feel the ribcage firmly

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    Step 14: checking for any grinding or disfigurement that could indicate broken bones.

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    Step 15: Checking the stomach: Again

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    Step 16: check for firmness/tenderness and any bulging in four sections of the abdomen.

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    Step 17: Checking the hips: Rock the hips gently from side-to-side and push down to check that they move freely and are not dislocated.

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    Step 18: If you must examine the genitals

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    Step 19: do so quickly and accurately.

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    Step 20: Checking the legs: Gradually move down the legs feeling for any grinding or visible disfigurement.

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    Step 21: Checking the arms: Follow the same steps as checking the legs but also; check for needle marks

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    Step 22: check for ID bracelet or medi-tag

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    Step 23: press nail beds and check that they turn white and then pink (this is commonly referred to as capillary refill).

Detailed Guide

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