TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam
2024, TNCC Prep, TNCC EXAM, TNCC 20th Edition Graded A+
- ANSPrehospital shock index pg. 85
.. activation: .... are found in the carotid sinus and along the aortic arch, are sensitive
to the degree of stretch in the arterial wall. When the receptors sense a decrease in
stretch, they stimulate the sympathetic nervous system to release Epi, norepi,
causing stimulation of cardiac activity and constriction of blood vessels, which
causes a rise in heart rate and diastolic blood pressure - ANSBaroreceptors:
1. A- airway and Alertness with simultaneous cervical spinal stabilization
2. B- breathing and Ventilation
3. circulation and control of hemorrhage
4. D - disability (neurologic status)
5. F - full set of vitals and Family presence
6. G - Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron
dioxide (ETC02) monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfaces - ANSABCDEFGHI
1. Apnea
2. GCS 8 or less
3. Maxillary fractures
4. Evidence of inhalation injury (facial burns)
5. Laryngeal or tracheal injury or neck hematoma
6. High risk of aspiration and patients inability to protect the airway
7. Compromised or ineffective ventilation - ANSFollowing conditions might require a
definitive airway
1. bony fractures and possible rib fractures, which may impact ventilation
2. palpate for crepitus
3. subcutaneous emphysema which may be a sign for a pneumothorax
4. soft tissue injury - ANSPalpate the chest for
1. Check the presence of adequate rise and fall of the chest with assisted ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
4. Presence of carbon dioxide (CO2) verified by a CO2 device or monitor - ANSIf the
pt has a definitive airway in what should you do?
1. Dyspnea
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam
2024, TNCC Prep, TNCC EXAM, TNCC 20th Edition Graded A+
2. Tachycardia
3. Decreased or absent breath sounds on the injured side
4. CP - ANSSimple Pneumo assessment:
1. equal breath sounds bilaterally at the second intercostal space midclavicular line
and the bases for fifth intercostal space at the axillary line - ANSAuscultate the
chest for:
1. Get a CT
2. Consider ABG 's if decreased LOC
3. Consider glucose check - ANSD Interventions
1. Hypotension
2. JVD
3. Muffled heart sounds - ANSBecks Triad:
1. open the airway, use jaw thrust
2. insert an oral airway
3. assist ventilations with a bag mask
4. prepare for definitive airway - ANSIf breathing is absent..
1. pain - hallmark sign, early sign
2. pressure - early sign
3. pallor, pules, paresthesia, paralysis - late sign - ANSSix P's of compartment
syndrome:
1. Preparation
2. Preoxygenation
3. Pretreatment
4. Paralysis and Induction
5. Protecting and positioning - v
6. Placement of proof - secure the tube
7. Post intubation - secure ETT Tube, get X-ray for placement - ANSSteps of Rapid
Sequence Intubation
1. Preparation and Triage
2. Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (HI) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse - ANSInitial Assessment
1. Suction the airway
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam
2024, TNCC Prep, TNCC EXAM, TNCC 20th Edition Graded A+
2, Use care to avoid stimulating the gag reflex
3. If the airway is obstructed by blood or vomitus secretions, use a rigid suction
device
If foreign body is noted, remove it carefully with forceps or another appropriate
method - ANSIf Airway is not patent
1. The tongue obstructing the airway
2. loose or missing teeth
3. foreign objects
4. blood, vomit, or secretions'
5. edema
6. burns or evidence of inhalation injury
Auscultiate or listen for:
1. Obstructive airway sounds such as snoring or gurgling
2. Possible occlusive maxillofacial bony deformity
3. Subcutaneous emphysema - ANSInspect the mouth for:
50 to 150 - ANSMAP Range
500 mL/hr - ANSYou are treating a 27 y/o M in respiratory distress who was involved
in a house fire. Calculating TBSA burned is deferred due to the need for emergent
intubation. At what rate should you begin fluid resuscitation?
A 14 gauge needle that is inserted into the 2nd intercostal space in the midclavicular
line on the affected side over the top of the rib to avoid neuromuscular bundle that
runs under the rib.
Prepare for chest tube placement. - ANSTension pneumo intervention
a 52 y/o diabetic male with a partial thickness burn to the left lower leg - ANSWhich
of the following patients warrants referral to a burn center?
A breath every 5 to 6 seconds: 10-12 ventilations per minute - ANSBag mask
ventilation
a pertinent medical hx is crucial - ANSWhich of the following considerations is the
most important when caring for a geriatric trauma pt?
According to newtons law which of these two force is greater: size or force? -
ANSNeither. For each force there is an equal and opposite reaction.
acidosis - ANSWhich of the following is a component of the trauma triad of death?
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam
2024, TNCC Prep, TNCC EXAM, TNCC 20th Edition Graded A+
activation: consist of carotid and aortic bodies. ... detect changes in blood oxygen
and Co2 and pH. When Co2 rises or oxygen level of pH falls these receptors are
activated and information is relayed to the CNS and the cardiorespiratory centers in
the medulla , which increases respiratory rage and depth and BP -
ANSChemoreceptors:
advanced age - ANSWhich of the following is most likely to contribute to inadequate
oxygenation and ventilation?
after a physical examination if the pt has no radiologic abnormalities on CT -
ANSEMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports
significant damage to the drivers side of the car. The pt is asking to have the
cervical collar removed. When it is appropriate to remove the cervical collar?
Air cannot escape intrapleural space.. can begin to compress heart. pt will have
sever resp distress, hypotension, JVD. - ANSTension pneumo
any deformities? bleeding? contusions, lacs? skin temp?? place splints on
deformities, pulses - ANSHead to toe assessment: Extremities
any lacs? deformities? blood at the urtheral meatus
palpate pelvis with high pressure over the iliac wings downward and medially -
ANSHead to toe assessment: pelvis and perineum
Aortic Dissection - ANSUnequal extremity pulse strength possibility of..
apply direct pressure to bleeding
elevate extremity
apply pressure over arterial sites
Consider a pelvic binder for pelvic fractures
consider a tourniquet
cannulate two veins with large caliber IV - if unable to gain assess consider IO
a. obtain labs, type and cross
b. infuse warm isotonic fluids
c. consider balanced resuscitation
d. use rapid infusion device - ANSC Interventions:
2024, TNCC Prep, TNCC EXAM, TNCC 20th Edition Graded A+
- ANSPrehospital shock index pg. 85
.. activation: .... are found in the carotid sinus and along the aortic arch, are sensitive
to the degree of stretch in the arterial wall. When the receptors sense a decrease in
stretch, they stimulate the sympathetic nervous system to release Epi, norepi,
causing stimulation of cardiac activity and constriction of blood vessels, which
causes a rise in heart rate and diastolic blood pressure - ANSBaroreceptors:
1. A- airway and Alertness with simultaneous cervical spinal stabilization
2. B- breathing and Ventilation
3. circulation and control of hemorrhage
4. D - disability (neurologic status)
5. F - full set of vitals and Family presence
6. G - Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron
dioxide (ETC02) monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfaces - ANSABCDEFGHI
1. Apnea
2. GCS 8 or less
3. Maxillary fractures
4. Evidence of inhalation injury (facial burns)
5. Laryngeal or tracheal injury or neck hematoma
6. High risk of aspiration and patients inability to protect the airway
7. Compromised or ineffective ventilation - ANSFollowing conditions might require a
definitive airway
1. bony fractures and possible rib fractures, which may impact ventilation
2. palpate for crepitus
3. subcutaneous emphysema which may be a sign for a pneumothorax
4. soft tissue injury - ANSPalpate the chest for
1. Check the presence of adequate rise and fall of the chest with assisted ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
4. Presence of carbon dioxide (CO2) verified by a CO2 device or monitor - ANSIf the
pt has a definitive airway in what should you do?
1. Dyspnea
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam
2024, TNCC Prep, TNCC EXAM, TNCC 20th Edition Graded A+
2. Tachycardia
3. Decreased or absent breath sounds on the injured side
4. CP - ANSSimple Pneumo assessment:
1. equal breath sounds bilaterally at the second intercostal space midclavicular line
and the bases for fifth intercostal space at the axillary line - ANSAuscultate the
chest for:
1. Get a CT
2. Consider ABG 's if decreased LOC
3. Consider glucose check - ANSD Interventions
1. Hypotension
2. JVD
3. Muffled heart sounds - ANSBecks Triad:
1. open the airway, use jaw thrust
2. insert an oral airway
3. assist ventilations with a bag mask
4. prepare for definitive airway - ANSIf breathing is absent..
1. pain - hallmark sign, early sign
2. pressure - early sign
3. pallor, pules, paresthesia, paralysis - late sign - ANSSix P's of compartment
syndrome:
1. Preparation
2. Preoxygenation
3. Pretreatment
4. Paralysis and Induction
5. Protecting and positioning - v
6. Placement of proof - secure the tube
7. Post intubation - secure ETT Tube, get X-ray for placement - ANSSteps of Rapid
Sequence Intubation
1. Preparation and Triage
2. Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (HI) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse - ANSInitial Assessment
1. Suction the airway
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam
2024, TNCC Prep, TNCC EXAM, TNCC 20th Edition Graded A+
2, Use care to avoid stimulating the gag reflex
3. If the airway is obstructed by blood or vomitus secretions, use a rigid suction
device
If foreign body is noted, remove it carefully with forceps or another appropriate
method - ANSIf Airway is not patent
1. The tongue obstructing the airway
2. loose or missing teeth
3. foreign objects
4. blood, vomit, or secretions'
5. edema
6. burns or evidence of inhalation injury
Auscultiate or listen for:
1. Obstructive airway sounds such as snoring or gurgling
2. Possible occlusive maxillofacial bony deformity
3. Subcutaneous emphysema - ANSInspect the mouth for:
50 to 150 - ANSMAP Range
500 mL/hr - ANSYou are treating a 27 y/o M in respiratory distress who was involved
in a house fire. Calculating TBSA burned is deferred due to the need for emergent
intubation. At what rate should you begin fluid resuscitation?
A 14 gauge needle that is inserted into the 2nd intercostal space in the midclavicular
line on the affected side over the top of the rib to avoid neuromuscular bundle that
runs under the rib.
Prepare for chest tube placement. - ANSTension pneumo intervention
a 52 y/o diabetic male with a partial thickness burn to the left lower leg - ANSWhich
of the following patients warrants referral to a burn center?
A breath every 5 to 6 seconds: 10-12 ventilations per minute - ANSBag mask
ventilation
a pertinent medical hx is crucial - ANSWhich of the following considerations is the
most important when caring for a geriatric trauma pt?
According to newtons law which of these two force is greater: size or force? -
ANSNeither. For each force there is an equal and opposite reaction.
acidosis - ANSWhich of the following is a component of the trauma triad of death?
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam
2024, TNCC Prep, TNCC EXAM, TNCC 20th Edition Graded A+
activation: consist of carotid and aortic bodies. ... detect changes in blood oxygen
and Co2 and pH. When Co2 rises or oxygen level of pH falls these receptors are
activated and information is relayed to the CNS and the cardiorespiratory centers in
the medulla , which increases respiratory rage and depth and BP -
ANSChemoreceptors:
advanced age - ANSWhich of the following is most likely to contribute to inadequate
oxygenation and ventilation?
after a physical examination if the pt has no radiologic abnormalities on CT -
ANSEMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports
significant damage to the drivers side of the car. The pt is asking to have the
cervical collar removed. When it is appropriate to remove the cervical collar?
Air cannot escape intrapleural space.. can begin to compress heart. pt will have
sever resp distress, hypotension, JVD. - ANSTension pneumo
any deformities? bleeding? contusions, lacs? skin temp?? place splints on
deformities, pulses - ANSHead to toe assessment: Extremities
any lacs? deformities? blood at the urtheral meatus
palpate pelvis with high pressure over the iliac wings downward and medially -
ANSHead to toe assessment: pelvis and perineum
Aortic Dissection - ANSUnequal extremity pulse strength possibility of..
apply direct pressure to bleeding
elevate extremity
apply pressure over arterial sites
Consider a pelvic binder for pelvic fractures
consider a tourniquet
cannulate two veins with large caliber IV - if unable to gain assess consider IO
a. obtain labs, type and cross
b. infuse warm isotonic fluids
c. consider balanced resuscitation
d. use rapid infusion device - ANSC Interventions: