DCAP-BTLS – Secondary Trauma Assessment

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DCAP-BTLS: A Simple Head-to-Toe Check for Hidden Injuries After you've handled the biggest dangers using MARCH-PAWS (like stopping massive bleeding, securing the airway, and preventing/treating shock and hypothermia), it's time for the next step: a careful full-body check. This is called the secondary assessment or head-to-toe exam. It helps you spot injuries that aren't immediately life- or limb-threatening but could become serious if missed—fractures, internal bleeding, infections, or hidden trauma that worsens over time. The easy way to remember what to look for is the acronym DCAP-BTLS (pronounced "dee-cap-bee-tells"). Perform this systematically from head to toe (and front to back if possible), while keeping the person's neck and spine stable if injury is suspected. Exposure may be reduced in extreme cold or wet conditions to prevent hypothermia—cut clothing only as needed and cover quickly. Perform DCAP-BTLS by body area: head, neck, chest, abdomen/pelvis, extremities (arms/legs), and back (if safe to roll the casualty). For each area, look (visual inspection), feel (palpate gently), and listen (for breath sounds, crepitus, etc.). Always compare injured to uninjured sides. D – Deformities Anything that looks out of shape, bent, or misaligned. Signs: Bent limbs at unnatural angles, visible bone ends (open fracture), asymmetric...