TNCC 9th Edition TNP
just keep evaluatng - vipp - ansWhat does the J stand for at the end of the secondary survery?
vital signs, injuries/interventions, primary survey, pain - ansWhat does VIPP stand for?
flank - ansDuring the head-to-toe, where would you find Grey-Turner's sign?
umbilicus - ansDuring the head-to-toe, where would you find Cullen's sign?
inspecting posterior - ansWhat is sometimes deferred at the end of the head-to-toe?
AFTER head-to-toe, BEFORE J (VIPP) - ansAntibiotics, consults, head CT, imaging, law
enforcement, mandatory reporting, psychosocial support, social services, splinting, tetanus,
and wound care are all interventions that you do AFTER and before WHAT?
Medical records, prehospital report, SAMPLE - ansWhat three items are obtained during the
pertinent history assessment?
Distraction, family presence, padding bony prominences, repositioning, splinting, verbal
reassurance - ansWhat are examples of nonpharmacologic measures? (must identify at least
one during testing)
all patients - ansFor whom is capnography highly recommended?
EKG - ansIn step M of "Get Adjuncts", what else might be indicated besides cardiac
monitor?
blankets, room temp increase, warmed fluids, warming lights - ansIn Step 16 of "Exposure
and Environment", you must name at least one of these interventions:
In Step 15 of "Exposure and Environment" - ansAt what point PRIOR TO the head-to-toe is
the patient inspected for obvious injuries?
glucose - ansIn Step 13 of "Disability", what is assessed if pt is altered?
1. inspect AND palpate skin color, temp, moisture and 2. palpate a pulse - ansTo assess
circulation, you must do these two main tasks:
intervene as appropriate and reassess - ansWhat do you do when alterations are identified in
any of the steps in the primary survery?
1. attach CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and fall of
the chest w/ assisted ventilations; 3. auscultate over epigastrium for gurgling AND lungs for
bilateral breath sounds - ansWhat three assessments must be done if the patient is intubated?
, Breath sounds, depth/pattern/rate, spontaneous breathing, subcutaneous emphysema,
increased work of breathing, symmetrical chest rise and fall, tracheal deviation/JVD, open
wounds/deformities, skin color - ansFour of these must be identified to assess breathing
effectiveness:
cardiac monitor - ansWhat can be applied in step 12 of "Circulation and Control of
Hemorrhage" for which credit is given in the LMNOP section?
During "Circulation" assessment - ansWhen should 2 IV sites be established?
assess ETT position by noting the number at teeth/gums AND secure ETT - ansIf the patient
is intubated and you've already assessed ETT placement, what else needs to be done with the
ETT? (step 10)
moving patient from assisted ventilation to mechanical - ansWhat should you verbalize after
completing all ETT assessments?
"Breathing and Ventilation" - ansDuring which part of the primary survey would you
anticipate the need for a chest tube, intubation, decompression of pneumothorax, oxygen, or
BVMs?
bony deformity, loose teeth, edema, inhalation injury, sounds, tongue obstruction, burns,
fluids, foreign objects, vocalization - ansFour of these must be identified to assess patency
and protection of the airway:
Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization" - ansDuring which
part of the primary survey would there be anticipation for intubation, insertion of OPA/NPA,
removal of any loose teeth or foreign objects, or suctioning?
the need for a second person to provide manual c-spine stabilization - ansIf c-spine
stabilization is necessary, what need should be stated?
A.Decrease the rate of manual ventilation. - ansAn adult patient who sustained a severe head
trauma has been intubated and is being manually ventilated via a bag-mask device at a rate of
18 breaths/minute. The patient has received one intravenous fluid bolus of 500 mL of
warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse
oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to manage
the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered.
post-concussive syndrome - ansAn older adult presents to the emergency department with
complaints of dizziness, headache, and nausea. The patient was involved in a motor vehicle
collision 10 days ago. There was no loss of consciousness and a hematoma is noted to the
forehead. The patient is currently on anticoagulant therapy. What is most likely the cause of
their symptoms?
just keep evaluatng - vipp - ansWhat does the J stand for at the end of the secondary survery?
vital signs, injuries/interventions, primary survey, pain - ansWhat does VIPP stand for?
flank - ansDuring the head-to-toe, where would you find Grey-Turner's sign?
umbilicus - ansDuring the head-to-toe, where would you find Cullen's sign?
inspecting posterior - ansWhat is sometimes deferred at the end of the head-to-toe?
AFTER head-to-toe, BEFORE J (VIPP) - ansAntibiotics, consults, head CT, imaging, law
enforcement, mandatory reporting, psychosocial support, social services, splinting, tetanus,
and wound care are all interventions that you do AFTER and before WHAT?
Medical records, prehospital report, SAMPLE - ansWhat three items are obtained during the
pertinent history assessment?
Distraction, family presence, padding bony prominences, repositioning, splinting, verbal
reassurance - ansWhat are examples of nonpharmacologic measures? (must identify at least
one during testing)
all patients - ansFor whom is capnography highly recommended?
EKG - ansIn step M of "Get Adjuncts", what else might be indicated besides cardiac
monitor?
blankets, room temp increase, warmed fluids, warming lights - ansIn Step 16 of "Exposure
and Environment", you must name at least one of these interventions:
In Step 15 of "Exposure and Environment" - ansAt what point PRIOR TO the head-to-toe is
the patient inspected for obvious injuries?
glucose - ansIn Step 13 of "Disability", what is assessed if pt is altered?
1. inspect AND palpate skin color, temp, moisture and 2. palpate a pulse - ansTo assess
circulation, you must do these two main tasks:
intervene as appropriate and reassess - ansWhat do you do when alterations are identified in
any of the steps in the primary survery?
1. attach CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and fall of
the chest w/ assisted ventilations; 3. auscultate over epigastrium for gurgling AND lungs for
bilateral breath sounds - ansWhat three assessments must be done if the patient is intubated?
, Breath sounds, depth/pattern/rate, spontaneous breathing, subcutaneous emphysema,
increased work of breathing, symmetrical chest rise and fall, tracheal deviation/JVD, open
wounds/deformities, skin color - ansFour of these must be identified to assess breathing
effectiveness:
cardiac monitor - ansWhat can be applied in step 12 of "Circulation and Control of
Hemorrhage" for which credit is given in the LMNOP section?
During "Circulation" assessment - ansWhen should 2 IV sites be established?
assess ETT position by noting the number at teeth/gums AND secure ETT - ansIf the patient
is intubated and you've already assessed ETT placement, what else needs to be done with the
ETT? (step 10)
moving patient from assisted ventilation to mechanical - ansWhat should you verbalize after
completing all ETT assessments?
"Breathing and Ventilation" - ansDuring which part of the primary survey would you
anticipate the need for a chest tube, intubation, decompression of pneumothorax, oxygen, or
BVMs?
bony deformity, loose teeth, edema, inhalation injury, sounds, tongue obstruction, burns,
fluids, foreign objects, vocalization - ansFour of these must be identified to assess patency
and protection of the airway:
Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization" - ansDuring which
part of the primary survey would there be anticipation for intubation, insertion of OPA/NPA,
removal of any loose teeth or foreign objects, or suctioning?
the need for a second person to provide manual c-spine stabilization - ansIf c-spine
stabilization is necessary, what need should be stated?
A.Decrease the rate of manual ventilation. - ansAn adult patient who sustained a severe head
trauma has been intubated and is being manually ventilated via a bag-mask device at a rate of
18 breaths/minute. The patient has received one intravenous fluid bolus of 500 mL of
warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse
oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to manage
the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered.
post-concussive syndrome - ansAn older adult presents to the emergency department with
complaints of dizziness, headache, and nausea. The patient was involved in a motor vehicle
collision 10 days ago. There was no loss of consciousness and a hematoma is noted to the
forehead. The patient is currently on anticoagulant therapy. What is most likely the cause of
their symptoms?
