ust keep evaluating - vipp - What does the J stand for at the end of the secondary survery?
vital signs, injuries/interventions, primary survey, pain - What does VIPP stand for?
flank - During the head-to-toe, where would you find Grey-Turner's sign?
umbilicus - During the head-to-toe, where wou...
TNCC 9th Edition TNP
just keep evaluating - vipp - ✔✔✔What does the J stand for at the end of the secondary survery?
vital signs, injuries/interventions, primary survey, pain - ✔✔✔What does VIPP stand for?
flank - ✔✔✔During the head-to-toe, where would you find Grey-Turner's sign?
umbilicus - ✔✔✔During the head-to-toe, where would you find Cullen's sign?
inspecting posterior - ✔✔✔What is sometimes deferred at the end of the head-to-toe?
AFTER head-to-toe, BEFORE J (VIPP) - ✔✔✔Antibiotics, consults, head CT, imaging, law enforcement,
mandatory reporting, psychosocial support, social services, splinting, tetanus, and wound care are all
interventions that you do AFTER and before WHAT?
Medical records, prehospital report, SAMPLE - ✔✔✔What three items are obtained during the
pertinent history assessment?
Distraction, family presence, padding bony prominences, repositioning, splinting, verbal reassurance - ✔
✔✔What are examples of nonpharmacologic measures? (must identify at least one during testing)
all patients - ✔✔✔For whom is capnography highly recommended?
EKG - ✔✔✔In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor?
blankets, room temp increase, warmed fluids, warming lights - ✔✔✔In Step 16 of "Exposure and
Environment", you must name at least one of these interventions:
,In Step 15 of "Exposure and Environment" - ✔✔✔At what point PRIOR TO the head-to-toe is the
patient inspected for obvious injuries?
glucose - ✔✔✔In Step 13 of "Disability", what is assessed if pt is altered?
1. inspect AND palpate skin color, temp, moisture and 2. palpate a pulse - ✔✔✔To assess circulation,
you must do these two main tasks:
intervene as appropriate and reassess - ✔✔✔What do you do when alterations are identified in any of
the steps in the primary survery?
1. attach CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and fall of the chest
w/ assisted ventilations; 3. auscultate over epigastrium for gurgling AND lungs for bilateral breath
sounds - ✔✔✔What three assessments must be done if the patient is intubated?
Breath sounds, depth/pattern/rate, spontaneous breathing, subcutaneous emphysema, increased work
of breathing, symmetrical chest rise and fall, tracheal deviation/JVD, open wounds/deformities, skin
color - ✔✔✔Four of these must be identified to assess breathing effectiveness:
cardiac monitor - ✔✔✔What can be applied in step 12 of "Circulation and Control of Hemorrhage" for
which credit is given in the LMNOP section?
During "Circulation" assessment - ✔✔✔When should 2 IV sites be established?
assess ETT position by noting the number at teeth/gums AND secure ETT - ✔✔✔If the patient is
intubated and you've already assessed ETT placement, what else needs to be done with the ETT? (step
10)
, moving patient from assisted ventilation to mechanical - ✔✔✔What should you verbalize after
completing all ETT assessments?
"Breathing and Ventilation" - ✔✔✔During which part of the primary survey would you anticipate the
need for a chest tube, intubation, decompression of pneumothorax, oxygen, or BVMs?
bony deformity, loose teeth, edema, inhalation injury, sounds, tongue obstruction, burns, fluids, foreign
objects, vocalization - ✔✔✔Four of these must be identified to assess patency and protection of the
airway:
Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization" - ✔✔✔During which part of the
primary survey would there be anticipation for intubation, insertion of OPA/NPA, removal of any loose
teeth or foreign objects, or suctioning?
the need for a second person to provide manual c-spine stabilization - ✔✔✔If c-spine stabilization is
necessary, what need should be stated?
A.Decrease the rate of manual ventilation. - ✔✔✔An adult patient who sustained a severe head
trauma has been intubated and is being manually ventilated via a bag-mask device at a rate of 18
breaths/minute. The patient has received one intravenous fluid bolus of 500 mL of warmed isotonic
crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm
Hg. What is the most important intervention to manage the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered.
post-concussive syndrome - ✔✔✔An older adult presents to the emergency department with
complaints of dizziness, headache, and nausea. The patient was involved in a motor vehicle collision 10
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