**A stands for ___ and ___. - ANSalertness, airway
**B stands for ___ and ___. - ANSbreathing, ventilation
**C stands for ___. - ANScirculation
**D stands for ___. - ANSdisability
**E stands for ___. - ANSexposure
After all of the assessments, interventions, reassessments, etc. are done, what is the
last thing to ask? - ANS"Is there anything you would like to add at this time?"
After how many breaths do you assess for the evidence of exhaled CO2? - ANSAfter 5
to 6 breaths.
After identifying potential interventions/diagnostics and completing your assessments
and interventions, you should ask yourself what? - ANS"What findings will you continue
to reevaluate while the patient is in your care?"
"Just keep re-evaluating"
After the head-to-toe, the learner should summarize injuries identified throughout the
scenario and ask themselves: - ANS"What interventions or diagnostics can you
anticipate for this patient?"
Continue the TNP assuming the patient was intubated. 9-11 - ANS9**. If intubated,
assess endotracheal tube placement
10. If intubated, assess ETT position and securement
11. If intubated, state the need to begin mechanical ventilation or continue assisted
ventilation
Continue the TNP following assessments of circulation, neuro status, and removal of
clothing to inspect for injury. 16-18 - ANS16. Provide warmth
17. Obtain a full set of vital signs and weight in kilograms (if not determined earlier)
18. Facilitate family presence
Continue the TNP following assessments of ETT. 12-15
**12, 13, and 15 are double-starred - ANS12**. Assess circulation
13**. Assess neurologic status using GCS
14. Assess pupils
15**. Remove all clothing AND inspect for obvious abnormalities or injuries
Continue the TNP using the LMNOP mnemonic. 19-23 - ANS19. L - trauma panel labs
20. M - monitor (Cardiac, consider EKG)
21. N - consider need for NG/OG
,22. O - assess O2 and end-tidal capnography
23**. P - assess pain using appropriate pain scale
Continue TNP after LMNOP (so after pain has been assessed). 24-26 - ANS24. Non-
pharmacological comfort measures
25. Consider analgesic med order
26. Obtain pertinent history
Double-starred criteria include letters ___-___. - ANSA-E
During the general impression in TNP, when alterations are identified, you must do
what? Then what? - ANSIntervene as appropriate and continuously reassess for
efficacy
Following the completion of head-to-toe assessment in TNP, you must do what? 44 -
ANS44. Identify at least THREE interventions or diagnostics
these may include the following:
Antibiotics
Consults
Head CT for any alterations in mental status
Imaging (other radiographs, CT, ultrasound, interventional radiology as indicated)
Law enforcement
Mandatory reporting
Psychosocial support
Social services
Splinting
Tetanus immunization
Wound care
For double-starred criteria, ___ and ___ must be completed prior to moving to the next
step. - ANSassessments, interventions
Give at least 4 examples of things to inquire about when assessing breathing efficacy: -
ANS- Breath sounds
- Depth, pattern, and general rate of respirations
- Increased work of breathing
- Open wounds or deformities
- Skin color
- Spontaneous breathing
- Subcutaneous emphysema
- Symmetrical chest rise and fall
- Tracheal deviation or jugular venous distention
,Give at least 4 examples of things to inquire about when assessing the patency and
protection of the airway: - ANSAcceptable things to ask about during this step include
assessments for:
- Bony deformity
- Burns
- Edema
- Fluids (blood, vomit, or secretions)
- Foreign objects
- Inhalation injury (burns, soot)
- Loose or missing teeth
- Sounds (snoring, gurgling, or stridor)
- Tongue obstruction
- Vocalization
Head-to-Toe 27-43 - ANS27. Inspect and palpate head for injuries
28. Inspect and palpate face for injuries
29. Inspect and palpate neck for injuries
-- Demonstrate removal AND reapplication of cervical collar for assessment (if
indicated).
30. Inspect and palpate chest for injuries
31. Auscultate breath sounds
32. Auscultate heart sounds
33. Inspect the abdomen for injuries
34. Auscultate bowel sounds
35. Palpate all four quadrants of the abdomen for injuries
36. Inspect and palpate the flanks for injuries
37. Inspect the pelvis for injuries
38. Apply gentle pressure over iliac crests downward and medially
39. Apply gentle pressure on the symphysis pubis (if iliac crests are stable)
40. Inspect the perineum for injuries
41. Consider GU - urinary output
42. Inspect and palpate all four extremities for neurovascular statu s and injuries
43. Inspect and palpate posterior surfaces -- NOT if the patient has suspected spinal or
pelvic injuries
How do you assess ETT position? - ANSby noting the number at the teeth or gums
How do you first assess for pelvic instability? Then wh at do you do? - ANSApply gentle
pressure over iliac crests downward and medially. If iliac crests are stable, then apply
gentle pressure on the symphysis pubis.
Identify at least one of the following when obtaining pertinent history: - ANS- Medical
records/documents
- Prehospital report
- SAMPLE
, If a patient is intubated, you must state... - ANSthe need to begin mechanical ventilation
or continue assisted ventilation
If alterations in oxygenation or EtCO2 are noted, interventions may include but are not
limited to the following: - ANS- Increase or decrease rate of assisted ventilation
- Wean oxygen (consider parameters other than oximetry due to hypothermia,
vasoconstriction, and skin color's impact on pulse oximetry measurements)
If intubated, you must assess which 2 things? - ANS1. Assess ETT position by noting
the number at the teeth or gums
2. Assess how the ETT is secured
If there are no contraindications, the patient may be turned to quickly assess the ___.
This is deferred until after the head-to-toe and imaging if needed to evaluate spinal and
pelvic stability. - ANSposterior
Just Keep Reevaluating. 45-48 - ANS45. Reevaluate vital signs
46. Reevaluate all identified injuries and effectiveness of interventions
47. Reevaluate primary survey
48. Reevaluate pain
L in LMNOP - ANSLabs
May include but not limited to the following:
Blood gases
Blood cross/type and screen
Coagulation studies
Complete blood count
Lactate
Metabolic panel
Pregnancy
Toxicology screen
M in LMNOP - ANSmonitor cardiac status and consider EKG
- also set BP to recycle as indicated
O in LMNOP - ANSoxygen and EtCO2
P in LMNOP - ANSassess pain
T/F: Delay removal of transport device when possible. - ANSFalse. If a transport device
is in place, it may be removed as soon as possible.
T/F: During the general impression, assessments and interventions identify life-
threatening conditions, and you should prioritize the life-saving interventions. Order of
**B stands for ___ and ___. - ANSbreathing, ventilation
**C stands for ___. - ANScirculation
**D stands for ___. - ANSdisability
**E stands for ___. - ANSexposure
After all of the assessments, interventions, reassessments, etc. are done, what is the
last thing to ask? - ANS"Is there anything you would like to add at this time?"
After how many breaths do you assess for the evidence of exhaled CO2? - ANSAfter 5
to 6 breaths.
After identifying potential interventions/diagnostics and completing your assessments
and interventions, you should ask yourself what? - ANS"What findings will you continue
to reevaluate while the patient is in your care?"
"Just keep re-evaluating"
After the head-to-toe, the learner should summarize injuries identified throughout the
scenario and ask themselves: - ANS"What interventions or diagnostics can you
anticipate for this patient?"
Continue the TNP assuming the patient was intubated. 9-11 - ANS9**. If intubated,
assess endotracheal tube placement
10. If intubated, assess ETT position and securement
11. If intubated, state the need to begin mechanical ventilation or continue assisted
ventilation
Continue the TNP following assessments of circulation, neuro status, and removal of
clothing to inspect for injury. 16-18 - ANS16. Provide warmth
17. Obtain a full set of vital signs and weight in kilograms (if not determined earlier)
18. Facilitate family presence
Continue the TNP following assessments of ETT. 12-15
**12, 13, and 15 are double-starred - ANS12**. Assess circulation
13**. Assess neurologic status using GCS
14. Assess pupils
15**. Remove all clothing AND inspect for obvious abnormalities or injuries
Continue the TNP using the LMNOP mnemonic. 19-23 - ANS19. L - trauma panel labs
20. M - monitor (Cardiac, consider EKG)
21. N - consider need for NG/OG
,22. O - assess O2 and end-tidal capnography
23**. P - assess pain using appropriate pain scale
Continue TNP after LMNOP (so after pain has been assessed). 24-26 - ANS24. Non-
pharmacological comfort measures
25. Consider analgesic med order
26. Obtain pertinent history
Double-starred criteria include letters ___-___. - ANSA-E
During the general impression in TNP, when alterations are identified, you must do
what? Then what? - ANSIntervene as appropriate and continuously reassess for
efficacy
Following the completion of head-to-toe assessment in TNP, you must do what? 44 -
ANS44. Identify at least THREE interventions or diagnostics
these may include the following:
Antibiotics
Consults
Head CT for any alterations in mental status
Imaging (other radiographs, CT, ultrasound, interventional radiology as indicated)
Law enforcement
Mandatory reporting
Psychosocial support
Social services
Splinting
Tetanus immunization
Wound care
For double-starred criteria, ___ and ___ must be completed prior to moving to the next
step. - ANSassessments, interventions
Give at least 4 examples of things to inquire about when assessing breathing efficacy: -
ANS- Breath sounds
- Depth, pattern, and general rate of respirations
- Increased work of breathing
- Open wounds or deformities
- Skin color
- Spontaneous breathing
- Subcutaneous emphysema
- Symmetrical chest rise and fall
- Tracheal deviation or jugular venous distention
,Give at least 4 examples of things to inquire about when assessing the patency and
protection of the airway: - ANSAcceptable things to ask about during this step include
assessments for:
- Bony deformity
- Burns
- Edema
- Fluids (blood, vomit, or secretions)
- Foreign objects
- Inhalation injury (burns, soot)
- Loose or missing teeth
- Sounds (snoring, gurgling, or stridor)
- Tongue obstruction
- Vocalization
Head-to-Toe 27-43 - ANS27. Inspect and palpate head for injuries
28. Inspect and palpate face for injuries
29. Inspect and palpate neck for injuries
-- Demonstrate removal AND reapplication of cervical collar for assessment (if
indicated).
30. Inspect and palpate chest for injuries
31. Auscultate breath sounds
32. Auscultate heart sounds
33. Inspect the abdomen for injuries
34. Auscultate bowel sounds
35. Palpate all four quadrants of the abdomen for injuries
36. Inspect and palpate the flanks for injuries
37. Inspect the pelvis for injuries
38. Apply gentle pressure over iliac crests downward and medially
39. Apply gentle pressure on the symphysis pubis (if iliac crests are stable)
40. Inspect the perineum for injuries
41. Consider GU - urinary output
42. Inspect and palpate all four extremities for neurovascular statu s and injuries
43. Inspect and palpate posterior surfaces -- NOT if the patient has suspected spinal or
pelvic injuries
How do you assess ETT position? - ANSby noting the number at the teeth or gums
How do you first assess for pelvic instability? Then wh at do you do? - ANSApply gentle
pressure over iliac crests downward and medially. If iliac crests are stable, then apply
gentle pressure on the symphysis pubis.
Identify at least one of the following when obtaining pertinent history: - ANS- Medical
records/documents
- Prehospital report
- SAMPLE
, If a patient is intubated, you must state... - ANSthe need to begin mechanical ventilation
or continue assisted ventilation
If alterations in oxygenation or EtCO2 are noted, interventions may include but are not
limited to the following: - ANS- Increase or decrease rate of assisted ventilation
- Wean oxygen (consider parameters other than oximetry due to hypothermia,
vasoconstriction, and skin color's impact on pulse oximetry measurements)
If intubated, you must assess which 2 things? - ANS1. Assess ETT position by noting
the number at the teeth or gums
2. Assess how the ETT is secured
If there are no contraindications, the patient may be turned to quickly assess the ___.
This is deferred until after the head-to-toe and imaging if needed to evaluate spinal and
pelvic stability. - ANSposterior
Just Keep Reevaluating. 45-48 - ANS45. Reevaluate vital signs
46. Reevaluate all identified injuries and effectiveness of interventions
47. Reevaluate primary survey
48. Reevaluate pain
L in LMNOP - ANSLabs
May include but not limited to the following:
Blood gases
Blood cross/type and screen
Coagulation studies
Complete blood count
Lactate
Metabolic panel
Pregnancy
Toxicology screen
M in LMNOP - ANSmonitor cardiac status and consider EKG
- also set BP to recycle as indicated
O in LMNOP - ANSoxygen and EtCO2
P in LMNOP - ANSassess pain
T/F: Delay removal of transport device when possible. - ANSFalse. If a transport device
is in place, it may be removed as soon as possible.
T/F: During the general impression, assessments and interventions identify life-
threatening conditions, and you should prioritize the life-saving interventions. Order of
