TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam,
TNCC Prep, TNCC EXAM, TNCC 10th Edition Graded A+
- ANSPrehospital shock index pg. 85
Explain Hypovolemic Shock. - ANSMost common to affect a trauma pt cause by
hypovolemia.. Hypovolemia, a decrease in amount of circulating blood volume, may
result from significant loss of whole blood because of hemorrhage or from loss of
semipermeable integrity of cellular membrane leading to leakage of plasma and
protein from intravascular space to the interstitial space (as in a burn).
Some causes:
- Blood loss
- Burns, etc.
Explain Irreversible Shock. - ANSShock uncompensated or irreversible stages will
cause compromises to most body systems.
- Inadequate venous return
- inadequate cardiac filling
- decreased coronary artery perfusion
- Membranes of lysosomes breakdown within cells and release digestive enzymes
that cause intracellular damage.
Explain Irreversible Shock. - ANSShock uncompensated or irreversible stages will
cause compromises to most body systems.
- Inadequate venous return
- inadequate cardiac filling
- decreased coronary artery perfusion
- Membranes of lysosomes breakdown within cells and release digestive enzymes
that cause intracellular damage.
Explain Obstructive Shock. - ANSResults from inadequate circulating blood volume
because of an obstruction or compression of great veins, aorta, pulmonary arteries,
or heart itself.
Some causes:
- Cardiac tamponade (may compress the heart during diastole to such and extent
that atria cannot adequately fill, leading to decreased stroke volume).
- Tension pneumothorax may lead to inadequate stroke volume by displacing inferior
vena cava and obstructing venous return to right atrium.
- Air embolus may lead to obstruction of pulmonary artery and subsequent
obstruction to right ventricular outflow during systole, with resulting obstructive
shock
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam,
TNCC Prep, TNCC EXAM, TNCC 10th Edition Graded A+
Explain Obstructive Shock. - ANSResults from inadequate circulating blood volume
because of an obstruction or compression of great veins, aorta, pulmonary arteries,
or heart itself.
Some causes:
- Cardiac tamponade (may compress the heart during diastole to such and extent
that atria cannot adequately fill, leading to decreased stroke volume).
- Tension pneumothorax may lead to inadequate stroke volume by displacing inferior
vena cava and obstructing venous return to right atrium.
- Air embolus may lead to obstruction of pulmonary artery and subsequent
obstruction to right ventricular outflow during systole, with resulting obstructive
shock
Explain Pulmonary Response. - ANSTachypnea happens for 2 reasons:
1. Maintain acid-base balance
2. Maintain increased supply of oxygen
* Metabolic acidosis from anaerobic metabolism will be a stimulus for the lungs to
increase rate of ventilation. Increased RR is an attempt to correct acidosis +
augments oxygen supply to maximize oxygen delivery to alveoli.
Explain Pulmonary Response. - ANSTachypnea happens for 2 reasons:
1. Maintain acid-base balance
2. Maintain increased supply of oxygen
* Metabolic acidosis from anaerobic metabolism will be a stimulus for the lungs to
increase rate of ventilation. Increased RR is an attempt to correct acidosis +
augments oxygen supply to maximize oxygen delivery to alveoli.
Exposure and Environmental Control
Remove all clothes and assess for any obvious injuries and uncontrolled bleeding -
ANSE
fat embolism - ANSa pt has been in the ED for several hrs waiting to be admitted. He
sustained multiple rib fractures and a femur fracture after a fall. He has been awake,
alert, and complaining of leg pain. His wife reported that he suddenly became
anxious and confused. Upon reassessment, the pt is restless with respiratory
distress and petechiae to his neck. The pt is exhibiting s/sx most commonly
associated with which of the following conditions?
Flail chest - ANSParadoxical chest wall movement
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam,
TNCC Prep, TNCC EXAM, TNCC 10th Edition Graded A+
flucuation in the water seal chamber - ANSWhich of the following is an expected
finding in a pt with a tube thoracstomy connected to a chest drainage system?
from hemorrhage is leading cause. Hypovolemia is caused by decrease in the amount
of circulating volume. Goal is to replace volume. - ANSHypovolemic Shock
Full set of vitals and family presence - ANSF
Get Resuscitation Adjuncts
L - Labs (maybe a lactic acid), a b g 's, blood type
M - monitors
N - naso or oro gastric tubes
O Oxygen and ETC02 monitors
P - pain assessment and management - ANSG
globe rupture - ANSA 35 y/o M presents with facial trauma after being struck in the
face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of
injury is suspected?
H,I - ANSSecondary Survery
hemoglobin does not readily release O2 for use by the tissues - ANSWhat is the
effect of hypothermia on the oxyhemoglobin dissociation curve?
History and Head to toe
MIST - prehospital report
MOI
Injuries sustained
S s/s in the field
T treatment in the field
if patients family present get a better hx on them - ANSH
How do you assess Mnemonic "D"? - ANSDISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
- Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam,
TNCC Prep, TNCC EXAM, TNCC 10th Edition Graded A+
How do you assess Mnemonic "D"? - ANSDISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
- Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
How do you confirm ET Tube/Alternative Airway Placement? - ANS- Visualization of
the chords
- Using bronchoscope to confirm placement
- Listening to breath sounds over the epigastrum and chest walls while ventilating
the pt
- CO2 detector
- Esophageal detection device
- Chest x-ray
How do you confirm ET Tube/Alternative Airway Placement? - ANS- Visualization of
the chords
- Using bronchoscope to confirm placement
- Listening to breath sounds over the epigastrum and chest walls while ventilating
the pt
- CO2 detector
- Esophageal detection device
- Chest x-ray
How do you inspect the chest for adequate ventilation? - ANSObserve:
- mental status
- RR and pattern
- chest wall symmetry
- any injuries
- patient's skin color (cyanosis?)
- JVD or tracheal deviation? (Tension pneumothorax)
How do you inspect the chest for adequate ventilation? - ANSObserve:
- mental status
- RR and pattern
- chest wall symmetry
- any injuries
- patient's skin color (cyanosis?)
TNCC Prep, TNCC EXAM, TNCC 10th Edition Graded A+
- ANSPrehospital shock index pg. 85
Explain Hypovolemic Shock. - ANSMost common to affect a trauma pt cause by
hypovolemia.. Hypovolemia, a decrease in amount of circulating blood volume, may
result from significant loss of whole blood because of hemorrhage or from loss of
semipermeable integrity of cellular membrane leading to leakage of plasma and
protein from intravascular space to the interstitial space (as in a burn).
Some causes:
- Blood loss
- Burns, etc.
Explain Irreversible Shock. - ANSShock uncompensated or irreversible stages will
cause compromises to most body systems.
- Inadequate venous return
- inadequate cardiac filling
- decreased coronary artery perfusion
- Membranes of lysosomes breakdown within cells and release digestive enzymes
that cause intracellular damage.
Explain Irreversible Shock. - ANSShock uncompensated or irreversible stages will
cause compromises to most body systems.
- Inadequate venous return
- inadequate cardiac filling
- decreased coronary artery perfusion
- Membranes of lysosomes breakdown within cells and release digestive enzymes
that cause intracellular damage.
Explain Obstructive Shock. - ANSResults from inadequate circulating blood volume
because of an obstruction or compression of great veins, aorta, pulmonary arteries,
or heart itself.
Some causes:
- Cardiac tamponade (may compress the heart during diastole to such and extent
that atria cannot adequately fill, leading to decreased stroke volume).
- Tension pneumothorax may lead to inadequate stroke volume by displacing inferior
vena cava and obstructing venous return to right atrium.
- Air embolus may lead to obstruction of pulmonary artery and subsequent
obstruction to right ventricular outflow during systole, with resulting obstructive
shock
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam,
TNCC Prep, TNCC EXAM, TNCC 10th Edition Graded A+
Explain Obstructive Shock. - ANSResults from inadequate circulating blood volume
because of an obstruction or compression of great veins, aorta, pulmonary arteries,
or heart itself.
Some causes:
- Cardiac tamponade (may compress the heart during diastole to such and extent
that atria cannot adequately fill, leading to decreased stroke volume).
- Tension pneumothorax may lead to inadequate stroke volume by displacing inferior
vena cava and obstructing venous return to right atrium.
- Air embolus may lead to obstruction of pulmonary artery and subsequent
obstruction to right ventricular outflow during systole, with resulting obstructive
shock
Explain Pulmonary Response. - ANSTachypnea happens for 2 reasons:
1. Maintain acid-base balance
2. Maintain increased supply of oxygen
* Metabolic acidosis from anaerobic metabolism will be a stimulus for the lungs to
increase rate of ventilation. Increased RR is an attempt to correct acidosis +
augments oxygen supply to maximize oxygen delivery to alveoli.
Explain Pulmonary Response. - ANSTachypnea happens for 2 reasons:
1. Maintain acid-base balance
2. Maintain increased supply of oxygen
* Metabolic acidosis from anaerobic metabolism will be a stimulus for the lungs to
increase rate of ventilation. Increased RR is an attempt to correct acidosis +
augments oxygen supply to maximize oxygen delivery to alveoli.
Exposure and Environmental Control
Remove all clothes and assess for any obvious injuries and uncontrolled bleeding -
ANSE
fat embolism - ANSa pt has been in the ED for several hrs waiting to be admitted. He
sustained multiple rib fractures and a femur fracture after a fall. He has been awake,
alert, and complaining of leg pain. His wife reported that he suddenly became
anxious and confused. Upon reassessment, the pt is restless with respiratory
distress and petechiae to his neck. The pt is exhibiting s/sx most commonly
associated with which of the following conditions?
Flail chest - ANSParadoxical chest wall movement
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam,
TNCC Prep, TNCC EXAM, TNCC 10th Edition Graded A+
flucuation in the water seal chamber - ANSWhich of the following is an expected
finding in a pt with a tube thoracstomy connected to a chest drainage system?
from hemorrhage is leading cause. Hypovolemia is caused by decrease in the amount
of circulating volume. Goal is to replace volume. - ANSHypovolemic Shock
Full set of vitals and family presence - ANSF
Get Resuscitation Adjuncts
L - Labs (maybe a lactic acid), a b g 's, blood type
M - monitors
N - naso or oro gastric tubes
O Oxygen and ETC02 monitors
P - pain assessment and management - ANSG
globe rupture - ANSA 35 y/o M presents with facial trauma after being struck in the
face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of
injury is suspected?
H,I - ANSSecondary Survery
hemoglobin does not readily release O2 for use by the tissues - ANSWhat is the
effect of hypothermia on the oxyhemoglobin dissociation curve?
History and Head to toe
MIST - prehospital report
MOI
Injuries sustained
S s/s in the field
T treatment in the field
if patients family present get a better hx on them - ANSH
How do you assess Mnemonic "D"? - ANSDISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
- Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
, TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exam,
TNCC Prep, TNCC EXAM, TNCC 10th Edition Graded A+
How do you assess Mnemonic "D"? - ANSDISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
- Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
How do you confirm ET Tube/Alternative Airway Placement? - ANS- Visualization of
the chords
- Using bronchoscope to confirm placement
- Listening to breath sounds over the epigastrum and chest walls while ventilating
the pt
- CO2 detector
- Esophageal detection device
- Chest x-ray
How do you confirm ET Tube/Alternative Airway Placement? - ANS- Visualization of
the chords
- Using bronchoscope to confirm placement
- Listening to breath sounds over the epigastrum and chest walls while ventilating
the pt
- CO2 detector
- Esophageal detection device
- Chest x-ray
How do you inspect the chest for adequate ventilation? - ANSObserve:
- mental status
- RR and pattern
- chest wall symmetry
- any injuries
- patient's skin color (cyanosis?)
- JVD or tracheal deviation? (Tension pneumothorax)
How do you inspect the chest for adequate ventilation? - ANSObserve:
- mental status
- RR and pattern
- chest wall symmetry
- any injuries
- patient's skin color (cyanosis?)
