TNCC Study Guide-comprehensive-2022-2023
Initial Assessment
● Preparation and Triage
○ Use universal precautions and don PPE
○ Consider any possible patient exposure to hazardous material that puts the trauma team
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TNCC Study Guide-comprehensive-2022-2023
Initial Assessment
● Preparation and Triage
○ Use universal precautions and don PPE
○ Consider any possible patient exposure to hazardous material that puts the trauma team at risk ○ Safe practice, safe care
○ Ensure resuscitation equipment is readily available
● Across the room observation to identify any uncontrolled external hemorrhage
○ Need to reprioritize to Circulation and Control of Hemorrhage
○ Uncontrolled hemorrhage is the major cause of preventable death in trauma patients
● Primary Survey - Inspect, Auscultate, Palpate
○ A: Airway and alertness with cervical spine stabilization
■ AVPU (Alert/verbal stimuli/painful stimuli/unresponsive)
■ Jaw-thrust maneuver to open the airway and assess for obstruction
● Tongue obstruction
● Loose teeth, foreign objects
● Blood, vomitus, secretions
● Edema
■ Listen for obstructive airway sounds (snoring, gurgling, stridor)
■ Feel for subcutaneous emphysema or deformities
■ Definitive Airway devices = ET tube
● Assess for proper placement (ETCO2, bilat breath sounds, absence of gurgling over the epigastrium)
■ Suction the airway if needed, then reassess
○ B: Breathing and ventilation
■ Are they breathing? How well are they breathing? How long can they keep it up?
■ Spontaneous breathing? Symmetrical rise and fall?
■ Depth, pattern, and rate
■ Skin color
■ Breath sounds
■ Palpate bony structures for possible rib fractures, subcutaneous emphysema, soft tissue injury ■
Open the airway if needed
● Use oral airway adjunct, assist ventilations, then prepare for definitive airway
○ C: Circulation and Control of Hemorrhage
■ Any signs of uncontrolled external bleeding?
● Apply direct pressure or use a tourniquet
■ Skin color, temp, and moisture?
■ Listen to heart and lung sounds
■ Palpate central pulses for rate, rhythm, and strength
■ 2 large-bore IVs
CONTINUED.....
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