TNCC EXAM
Major cause of death 1-44 - ✔✔✔Trauma: major cause of death for people ages 1-44 years
Epidemiology: Unintentional injury is a leading cause of death across all age groups in the US - ✔✔✔•
65+ falls are the leading cause of injury-related deaths
• 25-64: poisoning is the leading cause of death
• 5-24: MVC leading cause of death
• TBI: more for males, 0-4 highest rate of death
Injury prevention: 3 E's - ✔✔✔• Engineering: technological interventions (airbags, alarms, safety gear)
• Enforcement and legislation: laws and regulations
• Education: community based initiatives, public service announcements
Kinematics - ✔✔✔study of energy transfer as it applies to identifying actual or potential injuries
Biomechanics - ✔✔✔study of forces and their effects on living tissue and the human body
Mechanism of injury (MOI) - ✔✔✔how injuries occur as a result of energy from environment
transferred to the body
Newton's 1st law of motion: - ✔✔✔a body at rest will remain at rest, a body in motion will remain in
motion
Newton's 2nd law of motion: - ✔✔✔Force=Mass x Acceleration
,Newton's 3rd law of motion: - ✔✔✔for every action there is an equal and opposite reaction
Law of conservation of energy: - ✔✔✔energy can neither be created nor destroyed, but it can change
form
Types of injuries: - ✔✔✔• Blunt trauma: broad energy impact across a large surface area: falls, MVC,
assaults
• Penetrating trauma: energy that results in impalement: guns, stab wounds,
• Thermal trauma: burns
• Blast trauma: rapid release of blast energy in chemical, physical, radioactive exposures
• Occlusive/obtrusive: drowning, handing, strangulation,
Motor vehicle impact sequence: - ✔✔✔• 1st impact: car hit object
• 2nd: impact person hits inside of car
• 3rd: impact organs hit inside of body- organs can be ripped from ligaments (aorta) and hit internal
structures
Pedestrian vs Vehicle: - ✔✔✔Waddell triad: lower initial hit (leg), chest injury when landing on car
(thorax), upper body injury when bounced off and landing on the ground (head and arms)
Triage: - ✔✔✔sorting pt's based on their need for treatment and the resources available. Based on:
• MOI (head on collision, fall more than 20ft for adult)
• Physiologic criteria (vs)
• Anatomic critera (flail chest, fractured pelvis)
• Special considerations (age, special needs)
1. Prehospital report - ✔✔✔MIST (MOI, injury, s/s, treatment)
, 2. Preparation and triage: - ✔✔✔Safe practice, safe care
a. Activate trauma team
b. Right equipment, room ready
c. PPE
d. Consider any potential haz mat situation
3. Across the room observations - ✔✔✔C-AB: As pt is brought in rapid assess of stability and id of
uncontrolled bleeding
IF BLEEDING: CIRCULATION BEFORE AIRWAY! CONTROLL THE BLEED THEN MOVE TO AIRWAY
4. Primary survey: A-B-C-D-E-F-G (LMNOP) - ✔✔✔life-threatening conditions or identified and
immediately corrected
a. Alertness: AVPU W/ c-spine stabilization
AIRWAY ASSISTANCE W/ JAW THRUST W/C-SPINE CONTROL→ BVM if need assistance and/or difficult
airway
Look for: teeth/tongue/foreign bodies, blood/vomit/secretions, edema, burns (suction→ REASSESS)
Listen for: snoring, gurgling, stridor (OPA→REASSESS→ET→REASSESS)
Feel for: facial deformities, subcutaneous emphysema
ROBI: Reopen, OPA, BVM, Intubation→ reassess
*If ETT in place assess placement:
1. Adequate chest rise and fall w/ BVM
2. No epigastric gurgling
3. Bilateral breath sounds heard
4 CO2 detector gold
Interventions:
Major cause of death 1-44 - ✔✔✔Trauma: major cause of death for people ages 1-44 years
Epidemiology: Unintentional injury is a leading cause of death across all age groups in the US - ✔✔✔•
65+ falls are the leading cause of injury-related deaths
• 25-64: poisoning is the leading cause of death
• 5-24: MVC leading cause of death
• TBI: more for males, 0-4 highest rate of death
Injury prevention: 3 E's - ✔✔✔• Engineering: technological interventions (airbags, alarms, safety gear)
• Enforcement and legislation: laws and regulations
• Education: community based initiatives, public service announcements
Kinematics - ✔✔✔study of energy transfer as it applies to identifying actual or potential injuries
Biomechanics - ✔✔✔study of forces and their effects on living tissue and the human body
Mechanism of injury (MOI) - ✔✔✔how injuries occur as a result of energy from environment
transferred to the body
Newton's 1st law of motion: - ✔✔✔a body at rest will remain at rest, a body in motion will remain in
motion
Newton's 2nd law of motion: - ✔✔✔Force=Mass x Acceleration
,Newton's 3rd law of motion: - ✔✔✔for every action there is an equal and opposite reaction
Law of conservation of energy: - ✔✔✔energy can neither be created nor destroyed, but it can change
form
Types of injuries: - ✔✔✔• Blunt trauma: broad energy impact across a large surface area: falls, MVC,
assaults
• Penetrating trauma: energy that results in impalement: guns, stab wounds,
• Thermal trauma: burns
• Blast trauma: rapid release of blast energy in chemical, physical, radioactive exposures
• Occlusive/obtrusive: drowning, handing, strangulation,
Motor vehicle impact sequence: - ✔✔✔• 1st impact: car hit object
• 2nd: impact person hits inside of car
• 3rd: impact organs hit inside of body- organs can be ripped from ligaments (aorta) and hit internal
structures
Pedestrian vs Vehicle: - ✔✔✔Waddell triad: lower initial hit (leg), chest injury when landing on car
(thorax), upper body injury when bounced off and landing on the ground (head and arms)
Triage: - ✔✔✔sorting pt's based on their need for treatment and the resources available. Based on:
• MOI (head on collision, fall more than 20ft for adult)
• Physiologic criteria (vs)
• Anatomic critera (flail chest, fractured pelvis)
• Special considerations (age, special needs)
1. Prehospital report - ✔✔✔MIST (MOI, injury, s/s, treatment)
, 2. Preparation and triage: - ✔✔✔Safe practice, safe care
a. Activate trauma team
b. Right equipment, room ready
c. PPE
d. Consider any potential haz mat situation
3. Across the room observations - ✔✔✔C-AB: As pt is brought in rapid assess of stability and id of
uncontrolled bleeding
IF BLEEDING: CIRCULATION BEFORE AIRWAY! CONTROLL THE BLEED THEN MOVE TO AIRWAY
4. Primary survey: A-B-C-D-E-F-G (LMNOP) - ✔✔✔life-threatening conditions or identified and
immediately corrected
a. Alertness: AVPU W/ c-spine stabilization
AIRWAY ASSISTANCE W/ JAW THRUST W/C-SPINE CONTROL→ BVM if need assistance and/or difficult
airway
Look for: teeth/tongue/foreign bodies, blood/vomit/secretions, edema, burns (suction→ REASSESS)
Listen for: snoring, gurgling, stridor (OPA→REASSESS→ET→REASSESS)
Feel for: facial deformities, subcutaneous emphysema
ROBI: Reopen, OPA, BVM, Intubation→ reassess
*If ETT in place assess placement:
1. Adequate chest rise and fall w/ BVM
2. No epigastric gurgling
3. Bilateral breath sounds heard
4 CO2 detector gold
Interventions:
