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TCRN Exam Questions with 100% Correct Answers
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TCRN Exam Questions with 100% Correct Answers
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TCRNMost common mechanism of injury - Answer -Falls
Forms of energy - Answer --mechanical
-gravitational
-thermal
-chemical
Types of trauma - Answer --blunt
-penetrating
-burn
-other
Blunt trauma - Answer -accounts most injuries sustained
frontal impact
-aortic & cardiac injury, rib fxs, liver & spleen
-dash board posterior hip fx/dislocation, femur, knee injury
lateral impact
-head/facial, c spine, clavicle, pelvic, liver/spleen
rear end
,-low velocity, neck hyperextension/hyperflexn
rollover
-DAI
ejection
-risk of death 4x greater
pedestrian vs car
-tib/fib fx, truncal, head injury
bicycle
-head and abdominal injury from handlebar
falls
-4 stories 50% will die
-calcaneous, pelvis, spine, arm fx
Penetrating Trauma - Answer -lower incidence higher mortality
GSW
Stab: low velocity higher direct damage to organs
Burn: thermal or inhalation
Other: Hanging, strangulation , suffocation, drowning
Waddell's Triad - Answer --femoral shaft fx
-intrathoracic and abdominal injury
-contralateral head injury
Newton's three laws of motion - Answer -1. object at rest will stay at rest, object in motion will stay in
motion
2. Force: F=ma applying force produces acceleration (think seatbelt sign)
3. Action & Rxn: Every action there is an equal and opposite reaction
,ABCDE "do your job" Primary Survey - Answer -Airway obstruction is major cause of preventable trauma
deaths
Hemorrhage is the most common cause of mortality in trauma
Airway-get definitive airway
Circulation-IV access and IVF
Disability-assess LOC GCS scale
Exposure-get your pt naked! temperature control
-hypothermia=acidosis, coagulopathy, low O2
Hemorrhage Control-STOP THE BLEED replace volume loss, use tourniquet-note tourniquet time
-<6yo IO access preferred over central line
MTP
-1:1:1 pRBC:plasma:platelet
-pt receiving >10 units pRBC w/in 24 hrs admit
When is a definitive airway needed? - Answer -Edema, hemorrhage, fracture to obstruct airway and an
ET/NT cannot be placed
-closed head injury w/ GCS <8
-unresponsive
-neuromuscular paralysis
-apnea
-sustained seizure activity
-inability to protect lower airway from blood/secretion
Breathing Assessment - Answer --rate
-depth
-effort
-symmetry
-watch for tension pneumothorax!!
, Open pneumothorax dressing - Answer -3 sided dressing
Confirm airway placement - Answer --cords visualized
-chest rise and fall
-auscultate
-CO2 detector
-pulse ox
-CXR
Adult IVF bolus - Answer -1-2 liters if no contraindication
Pediatric IVF bolus - Answer -20ml/kg
Secondary Survey - Answer -a head-to-toe physical assessment; an additional assessment of a patient to
determine the existence of any injuries other than those found in the primary survey, history or scene
detail
Cardiac Output (L/min) - Answer -HR (beats/min) x SV (cc/beat)
Shock Definition - Answer -State in which perfusion is compromised @ cellular level d/t:
-insufficient oxygen delivery
-increased oxygen consumption
-ineffective oxygen utilization
Hypovolemic Shock - Answer -most common type shock: significant loss circulating volume most
common source acute blood loss (hemorrhage)
-AMS first sign of shock
-Tachycardia >120 very concerning-one of 1st signs
-Cool clammy skin d/t vasoconstriction
-prolonged CRT
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