| Head |
| Inspect and palpate face and scalp |
| Eye examination |
| Visual acuity (if alert) |
| Pupillary size |
| Hemorrhage (conjunctiva, fundi) |
| Penetrating injury |
| Contact lenses (remove if indicated) |
| Ocular entrapment |
| Periorbital ecchymosis (Raccoon eyes) |
| Ear examination |
| Hemotympanum, bleeding, perforation |
| Retro-auricular ecchymosis (Battle's sign) |
| Midface examination |
| Inspect for nasal swelling, deformity, bleeding, or clear rhinorrhea |
| Inspect for oral trauma, malocclusion, intraoral lacerations |
| Palpate maxilla for evidence of LeFort fracture (palatal instability with anterior to posterior pressure on the upper teeth) |
| Cervical spine and neck |
| If maxillofacial/head trauma sustained, presume unstable cervical spine injury and immobilize neck until c-spine adequately evaluated |
| Inspect and palpate neck |
| Tracheal deviation |
| Distended neck veins |
| C-spine tenderness |
| Subcutaneous emphysema |
| Crepitus over larynx (concerning for laryngeal fracture) |
| Carotid artery bruits |
| Active range of motion (in awake, cooperative patient without distracting injuries) |
| Penetrating neck injury |
| Inspect to determine if injury may be through the platysma |
| Chest |
| Inspect and palpate chest, including the clavicle, ribs, and sternum |
| Open pneumothorax/large flail segment |
| Crepitus |
| Tenderness/bony deformity |
| Auscultate |
| Breath sounds |
| Heart sounds |
