TNCC 9th Edition TNP
,What does the J stand for at the end of the secondary survery?
kr kr kr kr kr kr kr kr kr kr kr kr just keep evaluating - vipp
kr kr kr kr
What does VIPP stand for?kr kr kr kr vital signs, injuries/interventions, primary survey, pain
kr kr kr kr kr
During the head-to-toe, where would you find Grey-Turner's sign? flank
kr kr kr kr kr kr kr kr
During the head-to-toe, where would you find Cullen's sign?
kr kr kr kr kr kr kr kr umbilicus
What is sometimes deferred at the end of the head-to-toe? inspecting posterior
kr kr kr kr kr kr kr kr kr kr
Antibiotics, consults, head CT, imaging, law enforcement, mandatory reporting, psychosocial sup
kr kr kr kr kr kr kr kr kr kr
port, social services, splinting, tetanus, and wound care are all interventions that you do AFTER a
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
nd before WHAT?
kr AFTER head-to-toe, BEFORE J (VIPP)
kr kr kr kr kr
What three items are obtained during the pertinent history assessment?
kr kr kr kr kr kr kr kr kr
Medical records, prehospital report, SAMPLE kr kr kr kr
What are examples of nonpharmacologic measures? (must identify at least one during testing)
kr kr kr kr kr kr kr kr kr kr kr kr
Distraction, family presence, padding bony prominences, repositioning, splinting, verbal r kr kr kr kr kr kr kr kr kr
eassurance
For whom is capnography highly recommended?
kr kr kr kr kr all patients kr
In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor?
kr kr kr kr kr kr kr kr kr kr kr kr kr EKG
In Step 16 of "Exposure and Environment", you must name at least one of these interventions:
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
blankets, room temp increase, warmed fluids, warming lights kr kr kr kr kr kr kr
At what point PRIOR TO the head-to-toe is the patient inspected for obvious injuries?
kr kr kr kr kr kr kr kr kr kr kr kr kr
In Step 15 of "Exposure and Environment" kr kr kr kr kr kr
In Step 13 of "Disability", what is assessed if pt is altered? glucose
kr kr kr kr kr kr kr kr kr kr kr
To assess circulation, you must do these two main tasks:
kr kr kr kr kr kr kr kr kr
1. inspect AND palpate skin color, temp, moisture and 2. palpate a pulse
kr kr kr kr kr kr kr kr kr kr kr kr
What do you do when alterations are identified in any of the steps in the primary survery?
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
intervene as appropriate and reassess kr kr kr kr
What three assessments must be done if the patient is intubated?
kr kr kr kr kr kr kr kr kr kr
1. attach CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and fall
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr k
of the chest w/ assisted ventilations; 3. auscultate over epigastrium for gurgling AND lungs for bil
r kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ateral breath sounds kr kr
Four of these must be identified to assess breathing effectiveness:
kr kr kr kr kr kr kr kr kr
Breath sounds, depth/pattern/rate, spontaneous breathing, subcutaneous emphysema, i
kr kr kr kr kr kr kr
, ncreased work of breathing, symmetrical chest rise and fall, tracheal deviation/JVD, open wound
kr kr kr kr kr kr kr kr kr kr kr kr
s/deformities, skin color kr kr
What can be applied in step 12 of "Circulation and Control of Hemorrhage" for which credit is giv
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
en in the LMNOP section?
kr kr cardiac monitor kr kr kr
When should 2 IV sites be established?
kr kr kr kr kr kr During "Circulation" assessment kr kr
If the patient is intubated and you've already assessed ETT placement, what else needs to be don
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
e with the ETT? (step 10)
kr kr kr kr kr
assess ETT position by noting the number at teeth/gums AND secure ETT kr kr kr kr kr kr kr kr kr kr kr
What should you verbalize after completing all ETT assessments?
kr kr kr kr kr kr kr kr
moving patient from assisted ventilation to mechanical kr kr kr kr kr kr
During which part of the primary survey would you anticipate the need for a chest tube, intubati
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
on, decompression of pneumothorax, oxygen, or BVMs? "Breathing and Ventilation"
kr kr kr kr kr kr kr kr
Four of these must be identified to assess patency and protection of the airway:
kr kr kr kr kr kr kr kr kr kr kr kr kr
bony deformity, loose teeth, edema, inhalation injury, sounds, tongue obstruction, burns,
kr kr kr kr kr kr kr kr kr kr
fluids, foreign objects, vocalization
kr kr kr kr
During which part of the primary survey would there be anticipation for intubation, insertion of
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
OPA/NPA, removal of any loose teeth or foreign objects, or suctioning?
kr kr kr kr kr kr kr kr kr kr
Assessing patency and protection of the airway, Step 7 of kr kr kr kr kr kr kr kr kr kr
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization"
kr kr kr kr kr kr kr
If c-spine stabilization is necessary, what need should be stated?
kr kr kr kr kr kr kr kr kr
the need for a second person to provide manual c-spine stabilization
kr kr kr kr kr kr kr kr kr kr
An adult patient who sustained a severe head trauma has been intubated and is being manually
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ventilated via a bag- kr kr kr
mask device at a rate of 18 breaths/minute. The patient has received one intravenous fluid bolus
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the puls
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
e oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to manage the
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
cerebral blood flow? kr kr
A.Decrease the rate of manual ventilation. kr kr kr kr kr
B.Initiate another fluid bolus. kr kr kr
C.Re A.Decrease the rate of manual ventilation. kr kr kr kr kr
,What does the J stand for at the end of the secondary survery?
kr kr kr kr kr kr kr kr kr kr kr kr just keep evaluating - vipp
kr kr kr kr
What does VIPP stand for?kr kr kr kr vital signs, injuries/interventions, primary survey, pain
kr kr kr kr kr
During the head-to-toe, where would you find Grey-Turner's sign? flank
kr kr kr kr kr kr kr kr
During the head-to-toe, where would you find Cullen's sign?
kr kr kr kr kr kr kr kr umbilicus
What is sometimes deferred at the end of the head-to-toe? inspecting posterior
kr kr kr kr kr kr kr kr kr kr
Antibiotics, consults, head CT, imaging, law enforcement, mandatory reporting, psychosocial sup
kr kr kr kr kr kr kr kr kr kr
port, social services, splinting, tetanus, and wound care are all interventions that you do AFTER a
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
nd before WHAT?
kr AFTER head-to-toe, BEFORE J (VIPP)
kr kr kr kr kr
What three items are obtained during the pertinent history assessment?
kr kr kr kr kr kr kr kr kr
Medical records, prehospital report, SAMPLE kr kr kr kr
What are examples of nonpharmacologic measures? (must identify at least one during testing)
kr kr kr kr kr kr kr kr kr kr kr kr
Distraction, family presence, padding bony prominences, repositioning, splinting, verbal r kr kr kr kr kr kr kr kr kr
eassurance
For whom is capnography highly recommended?
kr kr kr kr kr all patients kr
In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor?
kr kr kr kr kr kr kr kr kr kr kr kr kr EKG
In Step 16 of "Exposure and Environment", you must name at least one of these interventions:
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
blankets, room temp increase, warmed fluids, warming lights kr kr kr kr kr kr kr
At what point PRIOR TO the head-to-toe is the patient inspected for obvious injuries?
kr kr kr kr kr kr kr kr kr kr kr kr kr
In Step 15 of "Exposure and Environment" kr kr kr kr kr kr
In Step 13 of "Disability", what is assessed if pt is altered? glucose
kr kr kr kr kr kr kr kr kr kr kr
To assess circulation, you must do these two main tasks:
kr kr kr kr kr kr kr kr kr
1. inspect AND palpate skin color, temp, moisture and 2. palpate a pulse
kr kr kr kr kr kr kr kr kr kr kr kr
What do you do when alterations are identified in any of the steps in the primary survery?
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
intervene as appropriate and reassess kr kr kr kr
What three assessments must be done if the patient is intubated?
kr kr kr kr kr kr kr kr kr kr
1. attach CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and fall
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr k
of the chest w/ assisted ventilations; 3. auscultate over epigastrium for gurgling AND lungs for bil
r kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ateral breath sounds kr kr
Four of these must be identified to assess breathing effectiveness:
kr kr kr kr kr kr kr kr kr
Breath sounds, depth/pattern/rate, spontaneous breathing, subcutaneous emphysema, i
kr kr kr kr kr kr kr
, ncreased work of breathing, symmetrical chest rise and fall, tracheal deviation/JVD, open wound
kr kr kr kr kr kr kr kr kr kr kr kr
s/deformities, skin color kr kr
What can be applied in step 12 of "Circulation and Control of Hemorrhage" for which credit is giv
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
en in the LMNOP section?
kr kr cardiac monitor kr kr kr
When should 2 IV sites be established?
kr kr kr kr kr kr During "Circulation" assessment kr kr
If the patient is intubated and you've already assessed ETT placement, what else needs to be don
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
e with the ETT? (step 10)
kr kr kr kr kr
assess ETT position by noting the number at teeth/gums AND secure ETT kr kr kr kr kr kr kr kr kr kr kr
What should you verbalize after completing all ETT assessments?
kr kr kr kr kr kr kr kr
moving patient from assisted ventilation to mechanical kr kr kr kr kr kr
During which part of the primary survey would you anticipate the need for a chest tube, intubati
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
on, decompression of pneumothorax, oxygen, or BVMs? "Breathing and Ventilation"
kr kr kr kr kr kr kr kr
Four of these must be identified to assess patency and protection of the airway:
kr kr kr kr kr kr kr kr kr kr kr kr kr
bony deformity, loose teeth, edema, inhalation injury, sounds, tongue obstruction, burns,
kr kr kr kr kr kr kr kr kr kr
fluids, foreign objects, vocalization
kr kr kr kr
During which part of the primary survey would there be anticipation for intubation, insertion of
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
OPA/NPA, removal of any loose teeth or foreign objects, or suctioning?
kr kr kr kr kr kr kr kr kr kr
Assessing patency and protection of the airway, Step 7 of kr kr kr kr kr kr kr kr kr kr
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization"
kr kr kr kr kr kr kr
If c-spine stabilization is necessary, what need should be stated?
kr kr kr kr kr kr kr kr kr
the need for a second person to provide manual c-spine stabilization
kr kr kr kr kr kr kr kr kr kr
An adult patient who sustained a severe head trauma has been intubated and is being manually
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ventilated via a bag- kr kr kr
mask device at a rate of 18 breaths/minute. The patient has received one intravenous fluid bolus
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the puls
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
e oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to manage the
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
cerebral blood flow? kr kr
A.Decrease the rate of manual ventilation. kr kr kr kr kr
B.Initiate another fluid bolus. kr kr kr
C.Re A.Decrease the rate of manual ventilation. kr kr kr kr kr
