1. Collins, Tara MSN, ACNP-BC, CRNP, CCRN
  2. McNicholas, Amanda MSN, CRNP
  3. Butler, Susan MSN, RN, CCRN


The tertiary survey was developed to diagnose injuries missed during the initial resuscitation. The utilization of computed tomographic scans as a screening tool has increased causing an increase in the prevalence of incidental findings. Our trauma advanced practitioner team initiated a comprehensive tertiary survey form, which holds the advanced practitioner accountable for both a tertiary physical examination and the communication of all incidental findings to the patient. This implementation correlated with a decrease in the rate of missed injuries. Because it was also found that few patients remembered having an incidental finding, further system changes are needed to improve communication of these incidental findings.