3. Ear—inspect for

a. Discharge from external auditory canal

b. Ecchymosis over mastoid (Battle’s sign)

c. Lacerations

d. Bleeding

4. Nose—inspect for

a. Rhinorrhea

b. Patent nostrils

c. Bleeding

d. Flaring of anterior nares on inspiration

5. Mouth

a. Inspect for

(1) Potential airway obstruction

(2) Edema or hemotoma

(3) Bleeding

(4) Teeth or dentures lodged in pharynx

(5) Misalignment of teeth

(6) Pain when biting teeth together

b. Palpate for fractures

(1) Zygomatic

(2) Mandible

(3) Maxilla

6. Neck

a. Inspect for

(1) Retraction bones at suprasternal notch on inspiration

(2) Deviation of trachea from midline

b. Auscultate for air sounds in trachea

7. Skin—inspect for

a. Jaundice

b. Cyanosis

c. Diaphoresis

d. Temperature

e. Moistness

f. Pallor

8. Thorax

a. Inspect for

(1) Respiration

(a) Rate—tachypnea

(b) Depth

1 Hyperpnea

2 Hypopnea

(c) Retraction of intercostal spaces

(2) Chest elevation symmetry—flail chest

(3) Lacerations, puncture, or ecchymosis

b. Palpate (unless there is a suspected spinal injury)

(1) Vertebrae and ribs for symmetry and tenderness

(2) Anterior to posterior compression of thorax

(3) Lateral-to-lateral compression of thorax

(4) Compression of clavicle

(5) Cranial to chordal compression

(6) Pressure of costochondral junction

(7) Compression on costovertebral angles

c. Auscultate for lung and heart sounds

(1) Lung sounds

(a) Absent or unequal breath

(b) Characteristics

1 Rales

2 Rhonchi

3 Wheezes

4 Strider

(2) Heart sounds

d. Percussion

(1) Fluid in thorax

(2) Pneumothorax or collapsed lung

9. Abdomen

a. Inspect for

(1) Lacerations, ecchymosis, burns, etc.

(2) Hematoma

(3) Flexion of hips to relieve pain

b. Auscultate bowel sounds

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