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What does the "A" in the TNCC primary survey represent?
Airway maintenance with cervical spine protection. Airway patency must be assessed
immediately while protecting the cervical spine in all trauma patients until injury is ruled out.
Define airway patency.
The ability of air to move freely from the nose/mouth through the trachea into the lungs without
obstruction.
A trauma patient is speaking in full sentences. What does this indicate?
The airway is currently patent and adequate airflow exists through the upper airway.
During trauma assessment, every patient is assumed to have a __________ injury until proven
otherwise.
Cervical spine.
What is the purpose of manual cervical spine stabilization?
To prevent movement of potentially unstable cervical vertebrae and avoid secondary spinal
cord injury.
A patient is snoring after a motorcycle crash. What is the likely cause?
Partial upper airway obstruction caused by the tongue occluding the airway.
What intervention is indicated for a snoring airway?
Open the airway using a jaw-thrust maneuver while maintaining cervical spine precautions.
What does gurgling during airway assessment suggest?
Blood, vomitus, secretions, or fluids in the airway requiring suctioning.
What does stridor indicate in a trauma patient?
Significant upper airway narrowing or obstruction and a potential airway emergency.
A patient is talking, so no further airway assessment is needed. True or False?
False. Airway status can deteriorate rapidly due to swelling, bleeding, or decreased
consciousness. Continuous reassessment is required.
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Define respiratory rate.
The number of breaths taken per minute and a key indicator of respiratory status.
What does the "B" in the primary survey represent?
Breathing and ventilation assessment.
Name three signs of respiratory distress.
Tachypnea, accessory muscle use, and abnormal breath sounds.
A trauma patient has absent breath sounds on the left side. What should you suspect?
Pneumothorax, hemothorax, or severe pulmonary injury.
Cyanosis is generally considered a __________ sign of hypoxia.
Late.
What is paradoxical chest movement?
A section of the chest wall moves opposite the rest of the chest during breathing, indicating flail
chest.
Define flail chest.
Fracture of multiple adjacent ribs in multiple places causing a free-floating chest segment.
What life-threatening condition may develop from flail chest?
Pulmonary contusion and respiratory failure.
What is the hallmark sign of tension pneumothorax?
Progressive respiratory distress with impaired ventilation and hemodynamic compromise.
Normal oxygen saturation completely rules out respiratory compromise. True or False?
False. Early compensation may maintain saturation despite significant injury.
What does the "C" in the primary survey represent?
Circulation with hemorrhage control.
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What is the leading preventable cause of trauma death?
Uncontrolled hemorrhage.
Define hemorrhagic shock.
Inadequate tissue perfusion due to significant blood loss.
What pulse characteristic may indicate early shock?
Rapid, weak, thready pulse.
A patient has cool, pale, clammy skin after trauma. What should be suspected?
Shock and inadequate tissue perfusion.
Direct __________ is the first-line intervention for external bleeding.
Pressure.
Why is blood pressure considered a late indicator of shock?
Compensatory mechanisms may maintain blood pressure despite substantial blood loss.
What is capillary refill assessment used for?
Evaluation of peripheral perfusion and circulatory status.
Define compensated shock.
A state in which physiological mechanisms maintain blood pressure despite reduced circulating
volume.
Define decompensated shock.
Failure of compensatory mechanisms leading to hypotension and organ hypoperfusion.
A normal blood pressure means shock is absent. True or False?
False. Patients may be in compensated shock despite normal blood pressure.
What does the "D" in the primary survey represent?
Disability or neurological assessment.
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What does the "A" in the TNCC primary survey represent?
Airway maintenance with cervical spine protection. Airway patency must be assessed
immediately while protecting the cervical spine in all trauma patients until injury is ruled out.
Define airway patency.
The ability of air to move freely from the nose/mouth through the trachea into the lungs without
obstruction.
A trauma patient is speaking in full sentences. What does this indicate?
The airway is currently patent and adequate airflow exists through the upper airway.
During trauma assessment, every patient is assumed to have a __________ injury until proven
otherwise.
Cervical spine.
What is the purpose of manual cervical spine stabilization?
To prevent movement of potentially unstable cervical vertebrae and avoid secondary spinal
cord injury.
A patient is snoring after a motorcycle crash. What is the likely cause?
Partial upper airway obstruction caused by the tongue occluding the airway.
What intervention is indicated for a snoring airway?
Open the airway using a jaw-thrust maneuver while maintaining cervical spine precautions.
What does gurgling during airway assessment suggest?
Blood, vomitus, secretions, or fluids in the airway requiring suctioning.
What does stridor indicate in a trauma patient?
Significant upper airway narrowing or obstruction and a potential airway emergency.
A patient is talking, so no further airway assessment is needed. True or False?
False. Airway status can deteriorate rapidly due to swelling, bleeding, or decreased
consciousness. Continuous reassessment is required.
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Define respiratory rate.
The number of breaths taken per minute and a key indicator of respiratory status.
What does the "B" in the primary survey represent?
Breathing and ventilation assessment.
Name three signs of respiratory distress.
Tachypnea, accessory muscle use, and abnormal breath sounds.
A trauma patient has absent breath sounds on the left side. What should you suspect?
Pneumothorax, hemothorax, or severe pulmonary injury.
Cyanosis is generally considered a __________ sign of hypoxia.
Late.
What is paradoxical chest movement?
A section of the chest wall moves opposite the rest of the chest during breathing, indicating flail
chest.
Define flail chest.
Fracture of multiple adjacent ribs in multiple places causing a free-floating chest segment.
What life-threatening condition may develop from flail chest?
Pulmonary contusion and respiratory failure.
What is the hallmark sign of tension pneumothorax?
Progressive respiratory distress with impaired ventilation and hemodynamic compromise.
Normal oxygen saturation completely rules out respiratory compromise. True or False?
False. Early compensation may maintain saturation despite significant injury.
What does the "C" in the primary survey represent?
Circulation with hemorrhage control.
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What is the leading preventable cause of trauma death?
Uncontrolled hemorrhage.
Define hemorrhagic shock.
Inadequate tissue perfusion due to significant blood loss.
What pulse characteristic may indicate early shock?
Rapid, weak, thready pulse.
A patient has cool, pale, clammy skin after trauma. What should be suspected?
Shock and inadequate tissue perfusion.
Direct __________ is the first-line intervention for external bleeding.
Pressure.
Why is blood pressure considered a late indicator of shock?
Compensatory mechanisms may maintain blood pressure despite substantial blood loss.
What is capillary refill assessment used for?
Evaluation of peripheral perfusion and circulatory status.
Define compensated shock.
A state in which physiological mechanisms maintain blood pressure despite reduced circulating
volume.
Define decompensated shock.
Failure of compensatory mechanisms leading to hypotension and organ hypoperfusion.
A normal blood pressure means shock is absent. True or False?
False. Patients may be in compensated shock despite normal blood pressure.
What does the "D" in the primary survey represent?
Disability or neurological assessment.
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