64 General Management of Trauma	519

Step 8: Sending investigations

Hemoglobin	ABG
Hematocrit	Renal function tests
Total leukocyte count	Electrolytes
Platelet count	Liver function tests
Prothrombin time	Blood grouping and crossmatching
Urine pregnancy test (14–45 years)	ECG (>40 years)
Breath/blood alcohol

Radiological

Plain radiographs

CT scanning

Contrast studies

Angiography

Ultrasound (including plain sonography echocardiography and color-flow Doppler)

Endoscopy

Step 9: Tertiary survey

•Tertiary survey consists of a repeat of the primary and secondary survey examinations, reassessment of the functions of all tubes and catheters, and review of all X-rays.

•It is routinely performed in the morning after the patient’s admission to detect any injuries not picked up earlier to minimize the missed injuries.

Suggested Reading

1.American College of Surgeons Committee on Trauma. Initial assessment and management. Advanced trauma life support program for doctors. 8th ed. Chicago: American College of Surgeons Committee on Trauma; 2008. pp. 1–18.

Comprehensive text in context with advanced trauma life support (ATLS) program.

2.Flint L, Meredith JW, Schwab C, editors. Trauma: contemporary principles and therapy. Philadelphia: Lippincott Williams & Wilkins; 2008.

3.Moore EE, Feliciano DV, Mattox KL, editors. Trauma. 5th ed. New York: McGraw-Hill; 2004. pp. 1067–8.

4.American College of Surgeons Committee on Trauma. Resources for optimal care of the trauma patient. Chicago: American College of Surgeons; 1998.

5.Super G, Groth S, Hook R, et al. START: Simple Triage and Rapid Treatment Plan. Newport Beach: Hoag Memorial Presbyterian Hospital; 1994.

This article explains the basis of triage of trauma victims.