TNCC study guide|100% COMPLETE VERIFIED PASS
TNCC study guide
. Describe the signs and symptoms of common chemical, biologic, radioactive, and
explosive agents. - anspg 318
3 impacts in a MVC - ans1. vehicle hits another object: occupant = acceleration
2. occupant collides with interior of vehicle: internal organs continue
3. internal structure collide with body
4 main types of traumatic injury - ans1. blunt trauma- falls; mvc; trauma
2. penetrating- stabing; GSW
3. Thermal
4. Blast Trauma- bomb
4. List the three components of the trauma triad of death. - ansAcidosis
hypothermial
coagulopathy
5 forms of energy that exist - ans1. Mechanical- energy transfer from one object to
another in form of motion
2. thermal-heat transfer from environment to host
3. chemical- heat energy trnsfer from active chemical substances such as chlorine,
drain cleaner, acids
4. electrical- energy transfer from light socket
5. radiant- energy transfer from blast sound waves, nuclear, rays from the sn
5 mechanisms of injury in a blast trauma - ansPrimary: blast injury; air-filled organs at
risk to rupture
secondary: fragment injuries; puncture wounds; lacerations
tertiary: impacts with larger objectes propelled by the blast win causing blunt trauma
quaternary: heat/flame/gas and smoke
quinary: exposure to hazardous materials (radioactive)
,TNCC study guide|100% COMPLETE VERIFIED PASS
7. Which lab value is unique to the administration of large amounts of banked blood and
why? - ansCalcium b/c blood bank adds citrate to blood and citrate binds to calcium.
Calcium is important for clotting
*significant if pt needs more than 1 unit of blood Q5 minutes
8. What criteria allow the trauma patient cervical spinal clearance using NEXUS? - ans-
no posterior midline cervical spine tenderness
-no evidence of intoxication is present
the pt has a normal level of alertness
-no focal neurologic deficit is present
-the pt does not have a painful distracting injury
Abrasion vs abulsion - anspartial or full thickness wounds that denues the skin (road
rash)
avulsion: full-thickness wounds. Edges are not well approximated
Assessment of airway - ansInsect for tongue obstruction; loose/missing teeth;
foreign objects;
blood, vomit, secretion;
edema
inhalation injury;
listen for gurgling/snoring/stridor;
palpate for occlusive maxillofacial bony deformity; subcutaneous emphysema
Biomechanics - ansgeneral study of forces and their effects
Characterisitcs of an effective team - ansdynamic
interdependent
adaptive
common goal
COMMUNICATION
COOPERATION
COORDINATION
Compensated shock - ans1. anxiety, lethargy, confusion, and restless
2. systolic BP = normal
3. rising diastolic BP = narrowed pulse pressure
4. bounding & tachy pulse
5. increased resp. rate
6. decreased urinary output
,TNCC study guide|100% COMPLETE VERIFIED PASS
deceleration vs acceleration forces - ans-Deceleration: injury that occurs as pt slows
down
acceleration injury: injury that occurs as a result of other parts of the body stopping
before the organs do (concussion; shearing of aorta)
Decompensated shock - ans1. LOC deteriorates
2. systolic BP= normal or a little lower
3. narrowing pulse pressure
4. tachycardia >100bpm
5. weak and thready pulse
6. rapid and shallow resp.
7. cool, clammy, cyanotic skin
8. base excess not within nomral range of -2 to +2
9. serum lactate levels greater than 2-4
Define an unstable pelvic fracture and list the presenting clinical findings. - ans2+
fractures of the pelvic ring that have outward rotaional displacement
assessment: shortening of the leg; external rotation of the leg; blood at the urinary
meatus or hematuria; pelvic instability/pain; unexplained hypotension or evidence of
hypovolemic shock
Define and list three types of primary brain injury. - ansskull and craniofacial fractures
intracranial lesions
lacerations, tearing, shearing and bleeding into brain
Define and provide assessment findings for postconcussive syndrome - ansmay
develop days or months following injury
nausea
dizziness and persistent headache
memory and judgment impairment
attention deficit
insomnia and sleep disturbances
loss of libido
anxiety; irritability; depression; emoional lability
noise and light oversensitivity
attention or concentration problems
Define anisocoria - ansunequal pupil size
Define damage control surgery and its purpose. - ansSurgery used only to stop the
bleeding, restore normothermia, and treat trauma triad. Lasts <90 minutes
later definitive injury repair is done once pt is more stable
, TNCC study guide|100% COMPLETE VERIFIED PASS
Define hyperoxia and the pulse oximetry parameters used to monitor it. - ansHyperoxia
refers to an excess supply of oxygen in the tissues. Better outcomes depend on prompt
titration of oxygen as indicated by maintaining SpO2 between 94-98%.
Define oligoanalgesia - ansunder treatment of pain
Define residual limb. - anspart of the body that remains after amputation
Define second impact syndrome. - anspt suffers a second mild TBI before recovery from
teh first
second impact causes loss of auto regulation leading to cerebral edema
Define the components of and use for the FOUR (Full Outline of UnResponsiveness)
Score. - ansEye response
Motor Response
Brainstem reflexs
Respirations
Define the components of capnography. - ans1. numeric value: shows info about
ventilation
2. Waveform: Respiratory cycle - change in waveform could mean bronchospasm,
obstruction, V/Q mismatch
3. PETCO2 -PaCO2 gradient: change can mean hemodynamic instability or decreasing
lung compliance
Define the components of cardiac output. - ansHeart rate x stroke volume= CP
Stroke volume impacted by preload, after load, contractility
Define the components of the Incident Command Structure. - ansUse common
terminology
Activate only what needs to be activated
Expect communication difficulties
One person is in charge
People manage 3-7 subordinates
Resource managment
designated incident facilities (shelter, food bank, morgues)
Define the four categories of disaster triage - ansExpectant: unlikely to survive
Immediate (red): medical attention needed within 60 minutes. Compromise ofABC
TNCC study guide
. Describe the signs and symptoms of common chemical, biologic, radioactive, and
explosive agents. - anspg 318
3 impacts in a MVC - ans1. vehicle hits another object: occupant = acceleration
2. occupant collides with interior of vehicle: internal organs continue
3. internal structure collide with body
4 main types of traumatic injury - ans1. blunt trauma- falls; mvc; trauma
2. penetrating- stabing; GSW
3. Thermal
4. Blast Trauma- bomb
4. List the three components of the trauma triad of death. - ansAcidosis
hypothermial
coagulopathy
5 forms of energy that exist - ans1. Mechanical- energy transfer from one object to
another in form of motion
2. thermal-heat transfer from environment to host
3. chemical- heat energy trnsfer from active chemical substances such as chlorine,
drain cleaner, acids
4. electrical- energy transfer from light socket
5. radiant- energy transfer from blast sound waves, nuclear, rays from the sn
5 mechanisms of injury in a blast trauma - ansPrimary: blast injury; air-filled organs at
risk to rupture
secondary: fragment injuries; puncture wounds; lacerations
tertiary: impacts with larger objectes propelled by the blast win causing blunt trauma
quaternary: heat/flame/gas and smoke
quinary: exposure to hazardous materials (radioactive)
,TNCC study guide|100% COMPLETE VERIFIED PASS
7. Which lab value is unique to the administration of large amounts of banked blood and
why? - ansCalcium b/c blood bank adds citrate to blood and citrate binds to calcium.
Calcium is important for clotting
*significant if pt needs more than 1 unit of blood Q5 minutes
8. What criteria allow the trauma patient cervical spinal clearance using NEXUS? - ans-
no posterior midline cervical spine tenderness
-no evidence of intoxication is present
the pt has a normal level of alertness
-no focal neurologic deficit is present
-the pt does not have a painful distracting injury
Abrasion vs abulsion - anspartial or full thickness wounds that denues the skin (road
rash)
avulsion: full-thickness wounds. Edges are not well approximated
Assessment of airway - ansInsect for tongue obstruction; loose/missing teeth;
foreign objects;
blood, vomit, secretion;
edema
inhalation injury;
listen for gurgling/snoring/stridor;
palpate for occlusive maxillofacial bony deformity; subcutaneous emphysema
Biomechanics - ansgeneral study of forces and their effects
Characterisitcs of an effective team - ansdynamic
interdependent
adaptive
common goal
COMMUNICATION
COOPERATION
COORDINATION
Compensated shock - ans1. anxiety, lethargy, confusion, and restless
2. systolic BP = normal
3. rising diastolic BP = narrowed pulse pressure
4. bounding & tachy pulse
5. increased resp. rate
6. decreased urinary output
,TNCC study guide|100% COMPLETE VERIFIED PASS
deceleration vs acceleration forces - ans-Deceleration: injury that occurs as pt slows
down
acceleration injury: injury that occurs as a result of other parts of the body stopping
before the organs do (concussion; shearing of aorta)
Decompensated shock - ans1. LOC deteriorates
2. systolic BP= normal or a little lower
3. narrowing pulse pressure
4. tachycardia >100bpm
5. weak and thready pulse
6. rapid and shallow resp.
7. cool, clammy, cyanotic skin
8. base excess not within nomral range of -2 to +2
9. serum lactate levels greater than 2-4
Define an unstable pelvic fracture and list the presenting clinical findings. - ans2+
fractures of the pelvic ring that have outward rotaional displacement
assessment: shortening of the leg; external rotation of the leg; blood at the urinary
meatus or hematuria; pelvic instability/pain; unexplained hypotension or evidence of
hypovolemic shock
Define and list three types of primary brain injury. - ansskull and craniofacial fractures
intracranial lesions
lacerations, tearing, shearing and bleeding into brain
Define and provide assessment findings for postconcussive syndrome - ansmay
develop days or months following injury
nausea
dizziness and persistent headache
memory and judgment impairment
attention deficit
insomnia and sleep disturbances
loss of libido
anxiety; irritability; depression; emoional lability
noise and light oversensitivity
attention or concentration problems
Define anisocoria - ansunequal pupil size
Define damage control surgery and its purpose. - ansSurgery used only to stop the
bleeding, restore normothermia, and treat trauma triad. Lasts <90 minutes
later definitive injury repair is done once pt is more stable
, TNCC study guide|100% COMPLETE VERIFIED PASS
Define hyperoxia and the pulse oximetry parameters used to monitor it. - ansHyperoxia
refers to an excess supply of oxygen in the tissues. Better outcomes depend on prompt
titration of oxygen as indicated by maintaining SpO2 between 94-98%.
Define oligoanalgesia - ansunder treatment of pain
Define residual limb. - anspart of the body that remains after amputation
Define second impact syndrome. - anspt suffers a second mild TBI before recovery from
teh first
second impact causes loss of auto regulation leading to cerebral edema
Define the components of and use for the FOUR (Full Outline of UnResponsiveness)
Score. - ansEye response
Motor Response
Brainstem reflexs
Respirations
Define the components of capnography. - ans1. numeric value: shows info about
ventilation
2. Waveform: Respiratory cycle - change in waveform could mean bronchospasm,
obstruction, V/Q mismatch
3. PETCO2 -PaCO2 gradient: change can mean hemodynamic instability or decreasing
lung compliance
Define the components of cardiac output. - ansHeart rate x stroke volume= CP
Stroke volume impacted by preload, after load, contractility
Define the components of the Incident Command Structure. - ansUse common
terminology
Activate only what needs to be activated
Expect communication difficulties
One person is in charge
People manage 3-7 subordinates
Resource managment
designated incident facilities (shelter, food bank, morgues)
Define the four categories of disaster triage - ansExpectant: unlikely to survive
Immediate (red): medical attention needed within 60 minutes. Compromise ofABC
