306277281-TNCC-Notes.doc - TNCC Review Notes TNCC Trauma Nursing Core Course A = Airway Check for Tongue obstruction Teeth Vocalization Blood\/vomit in

306277281-TNCC-Notes.doc - TNCC Review Notes TNCC Trauma...

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TNCC Review NotesTNCC: Trauma Nursing Core CourseA = Airway-Check for: Tongue obstructionTeethVocalizationBlood/vomit in airwayEdema-If obstruction Suction…then reassess-Maintain C-spine precautions-Prepare for intubationOnce intubated assess tube placement by auscultating over epigastrum first then over lung fieldsSecure endotracheal tubeB = Breathing-Is it spontaneous?-Accessory muscle use?-Rate and Pattern?-Skin color-Check for bilateral breath soundsIf breath sounds are not bilateral consider: tube placement/tension pneumothoraxIf there is JVD (jugular vein distention) or tracheal deviation perform needle thoracentisis…..Insert large bore needle into the 2ndintercostal space at the midclavicular line…..prepare for chest tube insertion.C = Circulation-Palpate central pulses (carotid/femoral)-Check color/temperature/moisture of skin-Check prehospital IV’s for patency-Start 2ndlarge bore IV. Obtain basic labs. Begin infusion of warmed fluid bolus-Check for obvious signs of external bleedingIf obvious signs of external bleeding Control bleedingD = Disability-Check AVPUAlert?Verbal?Responsive to Pain?Unresponsive?-Check pupils. Are they PERRL?EqualRound1
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TNCC Review NotesReactive toLightE = Expose the patient-Remove all clothes-Examine patient for obvious injuries/bleeding-Cover the patientUse warm blanketsIncrease room temperatureF = Full Set of Vitals/Family Presence/Foley-Obtain a full set of vitals-Question about family presence and allow them into room-Insert foley and/or gastric tube if indicatedG = Give Comfort-Obtain a pain rating-Obtain an order and provide analgesics-Provide comfort cares of injuries:IceElevationSplintingDressingsH = History/Head-to-Toe-Obtain a medical history-Perform a Head-to-Toe assessment noting all injuriesInspectAuscultatePalpateI = Inspect posterior surface/Identify Injuries/Interventions-Log roll patient maintaining C-spine precautionsInspect and palpate posterior surfaceMD to check rectal tone-Identify all injuries to patient-Consider InterventionsCT scanX-rayBasic LabsUltrasoundREEVALUATE THE PATIENT-Primary Assessment-Vitals-Pain Level-Interventions performed2
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TNCC Review NotesMNENOMICS TO KNOWMedications for Intubation: LOAD-L = Lidocaine (decreases intracranial pressure)-O = Opiates-A = Atropine (especially children)-D = Defasiculating (paralytic)Pre-Arrival History: MIVT-M = Mechanism-I = Injury-V = Vitals-T = TreatmentChest Tube/Intubation Trouble Shooting: DOPE-D = Dislodgement-O = Obstruction-P = Placement/Pneumothorax-E = EquipmentDisaster: DISASTER-D = Detection-I = Incident Command-S = Safety/Security-A = Assess Hazards-T = Triage & Treatment-E = Evacuation-R = Recovery6 P’s of Compartment Syndrome-Pain-Pallor-Pulses-Paresthesia-Paralysis-Pressure3
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TNCC Review NotesReview InformationChapter 3: Initial Assessment-
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  • Fall '19
  • abdominal trauma,  Insert

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