TNCC TRAUMA NURSING CORE COURSE 7TH EDITION ENA QUESTIONS WITH ANSWERS

Components of SBAR and its purpose - S: Situation B: Background A: Assessment R: Recommendation Purpose- to provide framework for communication amount members of the healthcare team p. 7 Components of DESC and its purpose - D: Describe the specific situation or behavior E: Express your concerns or how the situation makes you feel S: Suggest alternatives and seek agreement C: State consequences in terms of impact on performance goals Purpose- used in conflict management; paraphrasing the other person's comments is an important technique that should be done throughout the DESC script. Following discussion of consequences, team members should work towards consensus. p. 7 Components of CUS and its purpose - C: I am Concerned U: I am Uncomfortable S: This is a Safety issue/ I am Stressed Purpose- used to "stop the line" if a team member senses or discovers an essential safety breach p. 7 Define trauma - - Trauma is injury to living tissue caused by extrinsic agent - Regardless of MOI, trauma creates stressors that exceed the tissue's or organ's ability to compensate p. 9 Leading cause of death for ages 1. over 65 2. 5 to 24 3. 25 to 64 - 1. Falls 2. MVCs 3. poisoning p. 9 Explain 3 phases of injury prevention - Primary: prevention of the occurrence of the injury Secondary: Reduction in the severity of the injury that has occurred Tertiary: Improvement of outcomes related to the traumatic injury p. 10 Describe the three E's of injury control - Engineering: technological interventions such as side impact airbags, automated blind spot alarms, ignition lock devices for those with DUIs. In playgrounds and sports, this involves surface material under playground equipment and athletic safety gear. Another intervention is improved use of smoke alarms in fire prevention Enforcement and legislation: include laws at all jurisdictional levels regarding driving while intoxicated, booster seats, primary seatbelt use, and distracted driving. For sports this includes rules regarding illegal hits, examination after impact, and return-to-play requirements after a head injury Education: these can be community-based initiatives such as public service announcements for improved seatbelt use, education regarding risks of distracted driving, programs to commit to no texting while driving, and promotions for bicycle helmet giveaways with instructions for proper use p. 11 How can the trauma nurse have an impact when it comes to the legislative process? - By advocating for stronger laws and more consistent enforcement p. 11 Define kinematics - The study of energy transfer as it applies to identifying actual or intentional injuries p. 25 Define biomechanics - The general study of forces and their effects p. 25 Define mechanism of injury (MOI) - How external energy forces in the environment are transferred to the body p. 25 Newton's First Law of Motion - A body at rest will remain at rest, and a body in motion will stay in motion p. 26 Newton's Second Law of Motion - Force = Mass X Acceleration p. 26 Newton's Third Law of Motion - For every action, there is an equal and opposite reaction p. 26 Law of Conservation of Energy - Energy can neither be created nor destroyed, but it can change form p. 26 Describe energy forms - - Mechanical (energy transfer from one object to another in the form of motion) - Thermal (energy transfer of heat in environment to the host) - Chemical (heat energy transfer from active chemical substances such as chlorine, drain cleaner, acids, or plants) - Electrical (energy transfer from light socket, power lines, or lightning) - Radiant (energy transfer from blast sound waves, radioactivity such as a nuclear facility, or rays of the sun) p. 26 External energy forces can be exerted on the body by the following forces - - Deceleration forces: include those applied in falls and collisions where injuries are caused by sudden stop of the body's motion - Acceleration forces: not as common as deceleration forces and result from a sudden and rapid onset of motion (parked car being hit by a vehicle traveling at a high rate of speed) - Compression force is an external force applied at times of impact, explains include: + Stationary objects such as dashboards or steering wheels, that collide with or push up into a person + Objects in motion such as bullets and stabbing instruments, bats and balls, fists and feet, or heavy falling objects + Blast forces p. 27 The degree to which tissues resist destruction under circumstances of energy transfer depends on... - Their proximity to the impact and their structural characteristics p. 27 Structural strengths of tissue are described in what three ways? - -Compression -Tensile -Shear p. 27 Compression strength refers to the tissue's ability to: - Resist crush force - Compression injuries to organs occur when the organs are crushed from surrounding internal organs or structures such as a seatbelt worn up across the abdomen causing compression of the small bowel or a fracture to the lumbar spine p. 27 Tensile strength describes the tissue's ability to: - Resist pulling apart when stretched - Tendons, ligaments, and muscles can tear when they are overstretched (Achilles tendon) p. 27 Shear strength describes the tissue's ability to: - Resist a force applied parallel to the tissue - Coup/contrecoup injury, such as a boxer being hit in the head, is an example of this p. 27 Types of injuries include - - Blunt trauma - Penetrating trauma - Thermal trauma - Blast trauma