TNCC EXAM (2022 Study guide)
1. Preparation and Triage
2. Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (HI) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse
Initial Assessment
1. A- airway and Alertness with simultaneous cervical spinal stabilization2. B- breathing and
Ventilation
3. circulation and control of hemorrhage
4. D - disability (neurologic status)
5. F - full set of vitals and Family presence
6. G - Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron dioxide (ETC02)
monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfaces
ABCDEFGHI
Before the arrival of the pt
When should PPE be placed:
Pt is at hospital in the right amount of time, right care, right trauma facility, right resources
Safe Care:
Uncontrolled Hemorrhage
Major cause of preventable death:
reorganize care to C-ABC
If uncontrolled hemorrhage ..
, Used at the beginning of the initial assessment
1. A Alert. If the pt is alert he or she will be able to maintain his or her airway once it is clear.
2. V responds to verbal stimuli responds to pain. If the patient needs verbal stimulation to
respond, an airway adjunct may be needed to keep the tongue from obstructing the airway.
3. P responds to pain. If the pt. responds only to pain, he or she may not be able to maintain his
or her airway adjunct may need to be placed while further assessment is made to determine the
need for intubation.
4. U Unresponsive. If the pt. is unresponsive, announce it loudly to the team and direct someone
to chk in the pt is pulseless while assessing if the cause of the problem is the airway.
Airway and AVPU:
ask pt to pen his or her mouth
While assessing airway the patient is alert and responds to verbal stimuli you should..
jaw thrust maneuver to open airway and assess for obstruction. If pt has a suspected csi, the jaw
thrust procedure should be done by two providers. One provider can maintain c-spine and the
other can perform the jaw thrust maneuver.
While assessing airway pt is unable to open mouth, responds only to pain, or is unresponsive you
should..
1. The tongue obstructing the airway
2. loose or missing teeth
3. foreign objects
4. blood, vomit, or secretions'
5. edema
6. burns or evidence of inhalation injury
Auscultiate or listen for:
1. Obstructive airway sounds such as snoring or gurgling
2. Possible occlusive maxillofacial bony deformity
3. Subcutaneous emphysema
Inspect the mouth for:
1. Check the presence of adequate rise and fall of the chest with assisted ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
1. Preparation and Triage
2. Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (HI) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse
Initial Assessment
1. A- airway and Alertness with simultaneous cervical spinal stabilization2. B- breathing and
Ventilation
3. circulation and control of hemorrhage
4. D - disability (neurologic status)
5. F - full set of vitals and Family presence
6. G - Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron dioxide (ETC02)
monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfaces
ABCDEFGHI
Before the arrival of the pt
When should PPE be placed:
Pt is at hospital in the right amount of time, right care, right trauma facility, right resources
Safe Care:
Uncontrolled Hemorrhage
Major cause of preventable death:
reorganize care to C-ABC
If uncontrolled hemorrhage ..
, Used at the beginning of the initial assessment
1. A Alert. If the pt is alert he or she will be able to maintain his or her airway once it is clear.
2. V responds to verbal stimuli responds to pain. If the patient needs verbal stimulation to
respond, an airway adjunct may be needed to keep the tongue from obstructing the airway.
3. P responds to pain. If the pt. responds only to pain, he or she may not be able to maintain his
or her airway adjunct may need to be placed while further assessment is made to determine the
need for intubation.
4. U Unresponsive. If the pt. is unresponsive, announce it loudly to the team and direct someone
to chk in the pt is pulseless while assessing if the cause of the problem is the airway.
Airway and AVPU:
ask pt to pen his or her mouth
While assessing airway the patient is alert and responds to verbal stimuli you should..
jaw thrust maneuver to open airway and assess for obstruction. If pt has a suspected csi, the jaw
thrust procedure should be done by two providers. One provider can maintain c-spine and the
other can perform the jaw thrust maneuver.
While assessing airway pt is unable to open mouth, responds only to pain, or is unresponsive you
should..
1. The tongue obstructing the airway
2. loose or missing teeth
3. foreign objects
4. blood, vomit, or secretions'
5. edema
6. burns or evidence of inhalation injury
Auscultiate or listen for:
1. Obstructive airway sounds such as snoring or gurgling
2. Possible occlusive maxillofacial bony deformity
3. Subcutaneous emphysema
Inspect the mouth for:
1. Check the presence of adequate rise and fall of the chest with assisted ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
