Inital TNCC Assessment
Primary Assessment - answer A-Airway with Cspine protection,B-Breathing, C-
Circulation, D-Disability, E-Expose(remove clothing/Enviroment (keep warm)
Secondary Assessment - answer F-Full, Focused, Family, G-Give comfort, H-History,
Head to toe, I-Inspect posterior
Complete Spinal Immobilization inlcudes - answer Application of a rigid cervical collar,
placing the pt on a backboard and appropriate strapping to board. (2nd assessment)..
Where do you auscultate breath sounds? - answer At the 2nd intercostal space
midclavicular line and the at the 5th intercostal space at the anterior axillary line.
Late signs of breathing compromise are - answer Tracheal Deviation and Jugular Vein
distention.
What does AVPU stand for in the neurological Disability assessment? - answer A: Alert-
is pt alert and responsive.
V: Verbal- do they respond to verbal stimuli
P: Pain-Responds to painful stimulus.
U: Unresponsive.
(also check GCS score and pupils )
Things to assess for airway obstruction. - answer -Vocalization (crying moaning)
-Tongue obstructing the airway.
-Loose teeth or foreign objects.
-Blood, vomitus, secretions
-Edema.
What are the assessments for Breathing? - answer Spontaneous breathing, rise and fall
of chest, rate and pattern of breathing, Skin color, Intergrity of chest wall (soft tissue and
bony structures), Bilateral breath sounds.
After ET tube placement you must. - answer Observe for the rise and fall of the chest
with bag-valve ventilations.
Auscultate over the epigastric area AND then asucultate bilateral breath sounds
Use exhaled CO2 deterctor.
When you assess for circulation you - answer Assess central pulses, note obvious signs
of bleeding and LOC, look for vein distention.
Inspect and Palpate skin:
Assess for color (pale, pink), Temperature (warm, cold)
Moisture (Dry, Moist), Capillary refill.
Primary Assessment - answer A-Airway with Cspine protection,B-Breathing, C-
Circulation, D-Disability, E-Expose(remove clothing/Enviroment (keep warm)
Secondary Assessment - answer F-Full, Focused, Family, G-Give comfort, H-History,
Head to toe, I-Inspect posterior
Complete Spinal Immobilization inlcudes - answer Application of a rigid cervical collar,
placing the pt on a backboard and appropriate strapping to board. (2nd assessment)..
Where do you auscultate breath sounds? - answer At the 2nd intercostal space
midclavicular line and the at the 5th intercostal space at the anterior axillary line.
Late signs of breathing compromise are - answer Tracheal Deviation and Jugular Vein
distention.
What does AVPU stand for in the neurological Disability assessment? - answer A: Alert-
is pt alert and responsive.
V: Verbal- do they respond to verbal stimuli
P: Pain-Responds to painful stimulus.
U: Unresponsive.
(also check GCS score and pupils )
Things to assess for airway obstruction. - answer -Vocalization (crying moaning)
-Tongue obstructing the airway.
-Loose teeth or foreign objects.
-Blood, vomitus, secretions
-Edema.
What are the assessments for Breathing? - answer Spontaneous breathing, rise and fall
of chest, rate and pattern of breathing, Skin color, Intergrity of chest wall (soft tissue and
bony structures), Bilateral breath sounds.
After ET tube placement you must. - answer Observe for the rise and fall of the chest
with bag-valve ventilations.
Auscultate over the epigastric area AND then asucultate bilateral breath sounds
Use exhaled CO2 deterctor.
When you assess for circulation you - answer Assess central pulses, note obvious signs
of bleeding and LOC, look for vein distention.
Inspect and Palpate skin:
Assess for color (pale, pink), Temperature (warm, cold)
Moisture (Dry, Moist), Capillary refill.
