TNCC EXAM STUDY GUIDE SOLUTION (NEW SOLUION)
-Prehospital shock index pg. 85
.. activation: .... are found in the carotid sinus and along the aortic arch, are sensitive to the degree of stretch in the arterial wall. When the receptors sense a decrease in stretch, they stimulate the sympathetic ...
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TNCC EXAM STUDY GUIDE SOLUTION (NEW SOLUION)
-Prehospital shock index pg. 85
.. activation: .... are found in the carotid sinus and along the aortic arch, are sensitive to the
degree of stretch in the arterial wall. When the receptors sense a decrease in stretch, they
stimulate the sympathetic nervous system to release Epi, norepi, causing stimulation of
cardiac activity and constriction of blood vessels, which causes a rise in heart rate and
diastolic blood pressure -Baroreceptors:
1. A- airway and Alertness with simultaneous cervical spinal stabilization
2. B- breathing and Ventilation
3. circulation and control of hemorrhage
4. D - disability (neurologic status)
5. F - full set of vitals and Family presence
6. G - Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron dioxide
(ETC02) monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfaces -ABCDEFGHI
1. Apnea
2. GCS 8 or less
3. Maxillary fractures
4. Evidence of inhalation injury (facial burns)
5. Laryngeal or tracheal injury or neck hematoma
6. High risk of aspiration and patients inability to protect the airway
7. Compromised or ineffective ventilation -Following conditions might require a definitive
airway
, 1. bony fractures and possible rib fractures, which may impact ventilation
2. palpate for crepitus
3. subcutaneous emphysema which may be a sign for a pneumothorax
4. soft tissue injury -Palpate the chest for
1. Check the presence of adequate rise and fall of the chest with assisted ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
4. Presence of carbon dioxide (CO2) verified by a CO2 device or monitor -If the pt has a
definitive airway in what should you do?
1. Dyspnea
2. Tachycardia
3. Decreased or absent breath sounds on the injured side
4. CP -Simple Pneumo assessment:
1. equal breath sounds bilaterally at the second intercostal space midclavicular line and the
bases for fifth intercostal space at the axillary line -Auscultate the chest for:
1. Get a CT
2. Consider ABG 's if decreased LOC
3. Consider glucose check -D Interventions
1. Hypotension
2. JVD
3. Muffled heart sounds -Becks Triad:
1. open the airway, use jaw thrust
2. insert an oral airway
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