A detailed physical exam is indicated in the field when:

• A. After completing the primary survey if stable
• B. If there is a significant mechanism of injury or the patient is unconscious
• C. Only if the patient requests one
• D. During transport, not at the scene

Answer: (B)

In trauma care, a thorough head‑to‑toe secondary survey is done after you’ve checked for and addressed life threats in the primary survey. This detailed exam is most indicated when there is a significant mechanism of injury or the patient is unconscious because injuries can be hidden and the patient cannot report what hurts. A high‑risk mechanism (like a high‑speed crash, fall from height, or blast injury) increases the chance of multiple or complex injuries that aren’t obvious at first glance, and unconscious patients can’t communicate symptoms such as pain, numbness, or weakness. By performing a careful, systematic exam in these situations, you can detect occult injuries to the head, spine, chest, abdomen, pelvis, and extremities, establish a neurologic baseline, and make informed decisions about immobilization, splinting, bleeding control, and transport priorities.

Choosing not to do this only because the patient seems to be stable or because they request it isn’t appropriate in trauma, and waiting until transport or skipping the detailed exam would risk missing injuries that aren’t immediately evident.