Tertiary Survey Proforma for trauma – RHCG

Tertiary Survey proforma – ordered from Medical Illustration MI326638

The tertiary survey should be completed by a health care professional who is competent to assess a child for injuries. Examples of this are trauma/surgical ANP’s and any grade of medical practitioners who are involved in the patients inpatient care.

Tertiary Survey proforma – ordered from Medical Illustration MI326638

Aim of any repeat survey is to fully re-examine; formally review results of all investigations; consider cause of injury and any child protection concerns; focus on onward management plan; update the child and the family/carers.

The tertiary survey is ideally completed within first 48 hours of admission, or prior to discharge if less than 48 hours. If this is initially completed in PICU when the child remains sedated, this should then be repeated once transferred to the new receiving ward/team. The tertiary survey can be completed more than once per patient.

This SOP will be reviewed every two years.

The Major Trauma Coordinators will audit for compliance with use of the Tertiary Survey Proforma.

The tertiary survey is not necessarily required when end of life care is being discussed/considered.

Any planned or unplanned deviations from this SOP must be documented and reviewed by the appropriate personnel

For further information contact:
Major Trauma Coordinators
Ext: 84845/ 84930/ 84931

NOTE: This image should not be printed. Forms must be ordered from Medical Illustration (MI326638)