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TNCC EXAM QUESTIONS AND ANSWERS WELL ILLUSTRATED.TNCC EXAM QUESTIONS AND ANSWERS WELL ILLUSTRATED.TNCC EXAM QUESTIONS AND ANSWERS WELL ILLUSTRATED.TNCC EXAM QUESTIONS AND ANSWERS WELL ILLUSTRATED.TNCC EXAM QUESTIONS AND ANSWERS WELL ILLUSTRATED.
Typology: Exercises
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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
right resources: Safe Care:
once it is clear.
stimulation to respond, an airway adjunct may be needed to keep the tongue
from obstructing the airway.
able to maintain his or her airway adjunct may need to be placed while further
assessment is made to determine the need for intubation.
2 /
and direct someone to chk in the pt is pulseless while assessing if the cause
of the problem is the airway.: Airway and AVPU:
responds to verbal stimuli you should..
4 /
b. symmetrical rise and fall
c. depth, pattern, and rate of respiration
d. signs of difficulty breathing such as accessory muscle use
e. skin color (normal, pale, flushed, cyanotic)
f. contusions, abrasions, deformities (flail chest)
g. open pneumothoraces (sucking chest wounds)
h. JVD
i. signs of inhalation injury (singed nasal hairs, carbonaceous sputum): B
icular line and the bases for fifth intercostal space at the axillary line: Auscul-
tate the chest for:
oxygen delivery.: Oxygen on trauma patients
Inspect first for any uncontrolled bleeding
Skin color
palpate for central pulses - carotid and femoral - rate, rhythm, and strength
Skin temp: cool, diaphoretic, or warm and dry: C
elevate extremity
apply pressure over arterial sites
Consider a pelvic binder for pelvic fractures
consider a tourniquet
5 /
cannulate two veins with large caliber IV - if unable to gain assess consider
a. obtain labs, type and cross
b. infuse warm isotonic fluids
c. consider balanced resuscitation
d. use rapid infusion device: C Interventions:
Remove all clothes and assess for any obvious injuries and uncontrolled
bleeding: E
Maintain body temp - cover the pt, turn up heat in room, administer warm
fluids: E Interventions:
L - Labs (maybe a lactic acid), a b g 's, blood type
M - monitors
N - naso or oro gastric tubes
O Oxygen and ETC02 monitors
P - pain assessment and management: G
MIST - prehospital report
Injuries sustained
S s/s in the field
T treatment in the field
if patients family present get a better hx on them: H
S symptoms associated with injury
7 g/g
blogroll with at least 3 people. maintain c spine take out backboard Rectal tone per MD: I
ondary Reval Adjuncts
Interventions Primary survey Pain: Post resuscitation care parameters that are continuously evaluated:
indicating real-time measurement and trending over time.: Quantitative:
CO2. A chemically treated indicator strip changes color revealing the pres- ence or absence of exhaled CO2: Qualitative
O obstructed or kinked P pneumothorax E equipment failure , such as becoming detached from the equipment or loss of capnopgrahy: DOPE
Sequence Intubation
in the amount of circulating volume. Goal is to replace volume.: Hypovolemic Shock results from hypo perfusion to the tissue due to an obstruction in either vasculature or heart. Goal is to
8 g/g
Ex:gtensiongpneumogorgcardiacgtamponadegaregtwogclassicgexamplesgthatgma
ygresultgfromgtrauma.:gObstructivegShock
gume.gTheregisgaglackgofgcardiacgoutputgandgendgorgangperfusiongsecondarygt
ogagdecreasegingmyocardialgcontractilitygand/orgvalvularginsufficiency.
Ex:gMI'sgorgdysrhythmiagaregcommongcauses:gCariogenicgShock
dgvolumegwithgtheglossgofgvasculargtonegorgincreasedgpermeability.
Ex:gAnaphylacticg-greleasegofgantihistamines
SepticgShockg-
gsystemicgreleasegofgbacterialgendotoxins,gresultinggingincreasedgvasculargper
meabilitygandgvasodilation.gNeurogenicgshockg-
gspinalgcordginjurygresultsgofglossgingsympatheticgnervousgsystemgcontrolgofg
vasculargtone.
Goal:gVolumegreplacementgandgvasoconstriction:gDistributivegShock
12 gventilationsgpergminute:gBaggmaskgventilation
aregsensitivegtogthegdegreegofgstretchgingthegarterialgwall.gWhengthegreceptors
gsensegagdecreasegingstretch,gtheygstimulategthegsympatheticgnervousgsyste
mgtogreleasegEpi,gnorepi,gcausinggstimulationgofgcardiacgactivitygandgconstrict
iongofgbloodgvessels,gwhichgcausesgagrisegingheartgrategandgdiastolicgbloodgp
res-gsure:gBaroreceptors:
oxygengandgCo2gandgpH.gWhengCo2grisesgorgoxygenglevelgofgpHgfallsgthesegrec
eptorsgaregactivatedgandginformationgisgrelayedgtogthegCNSgandgthegcar-
gdiorespiratorygcentersgingthegmedullag,gwhichgincreasesgrespiratorygragegandg
depthgandgBP:gChemoreceptors:
egthegmoregacidicgyougare..
tgaregindicatorsgofgincreasedgperfusion?
10
g/g
gspacegandgnegativegintrapleuralgpressuregisglostgcausinggpartialgorgcollapse
dglung:gSimplegPneumothorax
gmaticgandgstable.gObservationgwithgorgwithoutgoxygen.gLargergpneumogwh
ogaregunstablegorglikelygtogdeteriorategagchestgtubegisgplaced.:gSimplegpneu
moginterventions:
egtrappedgingtogthegintrapleuralgplace.gMightghearg"sucking"
Tx:gnonporousgdressinggtapesgong 3 gsided,gthengChestgtubegandgwouldgclosureg
surgicalgrepair.:gOpengPneumo:
lghavegsevergrespgdistress,ghypotension,gJVD.:gTensiongpneumo
midclavicularglinegongthegaffectedgsidegovergthegtopgofgthegribgtogavoidgneuro
Preparegforgchestgtubegplacement.:gTensiongpneumogintervention
egorgspleengcombinedgwithginjurygtogthegdiaphragm.
EnsuregtwoglargegboregIVSgaregplaced.
Preparegforgthoracentesisgandgchestgtubeginsertion.gIfgopengthoracotomygisgdo
negchestgtubegisgdeferred.:gHemothorax:
lgevaluation.
(Ultrasoundgguided):gCardiacgTamponadegIntervention:
11
g/g
glategsign:gSixgP'sgofgcompartmentgsyn-gdrome:
gmusclegtone,ginteractiveness,gconsoloability,gpoorgorggaze,gspeechgorgcry
ginadequategorgexcessive,gaccessorygmuscleguse,gretrac-
gtions,gtripodgposition,gabnormalguppergairwaygsounds
gcolor,gmottlinggorgcentralgorgperipheralgcyanosis,gdiaphoresis:gPAT