TNCC: Trauma Nursing Core Course – Final Exam Overview
Initial Assessment - (ANSWER)1. Preparation and Triage
2. Primary Survey
3. Reevaluation
4. Secondary Survey
5. Reevaluation Adjuncts
6. Reevaluation and Post Resuscitation Care
7. Definitive Care or Transport
A (Primary Survey) - (ANSWER)Airway and alertness with simultaneous cervical spinal stabilization.
Alertness Assessment - (ANSWER)A-Alert
V-Verbal
P-Painful
U-Unresponsive
Airway Assessment - (ANSWER)Inspect: tongue obstruction, loose/missing teeth, foreign objects, blood,
vomitus, secretions, edema, burns or evidence of inhalation injury
Auscultate: listen for obstructive airway sounds (ie. snoring, gurgling, stridor)
Palpate: palpate for possible occlusive maxillofacial bony deformity, subcutaneous emphysema
Airway Interventions: - (ANSWER)Suction
Remove foreign body if noted
Jaw thrust maneuver (maintain cspine)
Nasopharyngeal airway (can be conscious) Oropharyngeal airway (no gag)
Consider definitive airway
, TNCC: Trauma Nursing Core Course – Final Exam Overview
A (AVPU) - (ANSWER)Alert. Will be able to maintain airway once clear.
V (AVPU) - (ANSWER)Verbal. Needs verbal stimuli to respond.
(Airway adjunct may be needed to prevent tongue obstruction)
P (AVPU) - (ANSWER)Painful. Responds only to painful stimuli.
(Airway adjunct may be needed while determining need for intubation)
U (AVPU) - (ANSWER)Unresponsive. Does not respond to any stimuli.
B (Primary Survey) - (ANSWER)Breathing and Ventilation
Breathing and Ventilation Assessment - (ANSWER)Inspect: spontaneous breathing, symmetrical rise and
fall, depth/pattern/rate of respirations, accessory muscle use, diaphragmatic breathing, skin color
(normal, pale, flushed, cyanotic), contusions/abrasions/deformities (signs of underlying injury), open
pneumothoraces (sucking chest wound), JVD, tracheal position, signs of inhalation injury
Auscultate: presence, absence and equality of breath sounds at 2nd intercostal space midclavicular line
and bases at the fifth intercostal space anterior axillary line
Palpate: bony structures, possible rib fractures, SQ emphysema, soft tissue injury, JV pulsations at
suprasternal notch or supraclavicular area
Life-threatening pulmonary injuries requiring immediate intervention: open pneumothorax, tension
pneumothorax, flail chest, hemothorax.
Breathing and Ventilation Intervention - (ANSWER)Breathing absent: jaw-thrust maneuver, oral airway
adjunct, assist ventilation with bag-mask device, prepare for definitive airway
Initial Assessment - (ANSWER)1. Preparation and Triage
2. Primary Survey
3. Reevaluation
4. Secondary Survey
5. Reevaluation Adjuncts
6. Reevaluation and Post Resuscitation Care
7. Definitive Care or Transport
A (Primary Survey) - (ANSWER)Airway and alertness with simultaneous cervical spinal stabilization.
Alertness Assessment - (ANSWER)A-Alert
V-Verbal
P-Painful
U-Unresponsive
Airway Assessment - (ANSWER)Inspect: tongue obstruction, loose/missing teeth, foreign objects, blood,
vomitus, secretions, edema, burns or evidence of inhalation injury
Auscultate: listen for obstructive airway sounds (ie. snoring, gurgling, stridor)
Palpate: palpate for possible occlusive maxillofacial bony deformity, subcutaneous emphysema
Airway Interventions: - (ANSWER)Suction
Remove foreign body if noted
Jaw thrust maneuver (maintain cspine)
Nasopharyngeal airway (can be conscious) Oropharyngeal airway (no gag)
Consider definitive airway
, TNCC: Trauma Nursing Core Course – Final Exam Overview
A (AVPU) - (ANSWER)Alert. Will be able to maintain airway once clear.
V (AVPU) - (ANSWER)Verbal. Needs verbal stimuli to respond.
(Airway adjunct may be needed to prevent tongue obstruction)
P (AVPU) - (ANSWER)Painful. Responds only to painful stimuli.
(Airway adjunct may be needed while determining need for intubation)
U (AVPU) - (ANSWER)Unresponsive. Does not respond to any stimuli.
B (Primary Survey) - (ANSWER)Breathing and Ventilation
Breathing and Ventilation Assessment - (ANSWER)Inspect: spontaneous breathing, symmetrical rise and
fall, depth/pattern/rate of respirations, accessory muscle use, diaphragmatic breathing, skin color
(normal, pale, flushed, cyanotic), contusions/abrasions/deformities (signs of underlying injury), open
pneumothoraces (sucking chest wound), JVD, tracheal position, signs of inhalation injury
Auscultate: presence, absence and equality of breath sounds at 2nd intercostal space midclavicular line
and bases at the fifth intercostal space anterior axillary line
Palpate: bony structures, possible rib fractures, SQ emphysema, soft tissue injury, JV pulsations at
suprasternal notch or supraclavicular area
Life-threatening pulmonary injuries requiring immediate intervention: open pneumothorax, tension
pneumothorax, flail chest, hemothorax.
Breathing and Ventilation Intervention - (ANSWER)Breathing absent: jaw-thrust maneuver, oral airway
adjunct, assist ventilation with bag-mask device, prepare for definitive airway
