TNCC ENA 9TH EDITION 2026
CERTIFICATION EVALUATION SCRIPT
SOLUTIONS GRADED A+
⩥ 1. A- airway and Alertness with simultaneous cervical spinal
stabilization
2. 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.
Answer: ABCDEFGHI
⩥ Before the arrival of the pt.
Answer: When should PPE be placed:
,⩥ Pt is at hospital in the right amount of time, right care, right trauma
facility, right resources.
Answer: Safe Care:
⩥ Uncontrolled Hemorrhage.
Answer: Major cause of preventable death:
⩥ reorganize care to C-ABC.
Answer: 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..
, Answer: Airway and AVPU:
⩥ ask pt to pen his or her mouth.
Answer: 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..
Answer: 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
CERTIFICATION EVALUATION SCRIPT
SOLUTIONS GRADED A+
⩥ 1. A- airway and Alertness with simultaneous cervical spinal
stabilization
2. 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.
Answer: ABCDEFGHI
⩥ Before the arrival of the pt.
Answer: When should PPE be placed:
,⩥ Pt is at hospital in the right amount of time, right care, right trauma
facility, right resources.
Answer: Safe Care:
⩥ Uncontrolled Hemorrhage.
Answer: Major cause of preventable death:
⩥ reorganize care to C-ABC.
Answer: 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..
, Answer: Airway and AVPU:
⩥ ask pt to pen his or her mouth.
Answer: 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..
Answer: 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
