TNCC 7th Edition is a Soup Sandwich!

Specialties Emergency

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Seriously? No mention of a Foley during the "Trauma Nursing Process?" Receiving report from EMS during the Secondary Survey? Not just a bad idea, but disrespectful to our EMS Colleagues! Is the Nursing Echo Chamber on the Ivory Tower now so loud that it is now drowning out common sense? Thanks ENA! Next time it's going to be ATCN re-certification & skip TNCC!

I'm taking TNCC 7th right now.

The silliest take-away at this point is that vital signs aren't obtained until after ABCDE.

My trauma experience is in a busy level 1 and a not-so-busy level 2 and in both places, an initial blood pressure (either palp or manual) is required immediately upon arrival. One nurse's top priority upon arrival is that BP and a tech immediately places them on the monitor.

Regarding Foleys, I do notice that they've now de-emphasized placing a Foley as a somewhat routine matter as it was in TNCC 6.

As mentioned above, TNCC needs to be considered in the context of the target audience. In my level 1 role, there's nothing new that I've come across in TNCC 7. When I took TNCC 6, I was working in tiny, rural facility that saw very, very little trauma and TNCC 6 was (a) helpful, (b) a bit overwhelming, and © not entirely applicable.

I think it's not wise to look at the ABCDE protocol and believe you do not move on to step 2 until you've completed step one, etc. I am lucky enough to work at one of the best trauma hospitals in the country. The reality is many of the steps happen simultaneously. So, no, you do not wait until after E to do vitals. However, you also don't put off certain things that are of higher priority to do vitals. It's just like once you've established airway is intact, you're done assessing it. You reassess repeatedly because things change.

Regarding foleys, our facility is following recent literature and using them less.

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Really? I'm being serious with my question, do you not place Foleys in most of your traumas? We put Foleys in most of our traumas to monitor output and gauge fluid resuscitation.

Foley's are not benign. A UTI can be more dangerous in lots of patients than most "trauma" that rolls thru the door.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Foley's are not benign. A UTI can be more dangerous in lots of patients than most "trauma" that rolls thru the door.

Right. We discussed this on the first page of this thread, making a distinction between traumas, Traumas, and TRAUMAS. :D

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Hey guys I just took tncc last month and it was really stressed to us that the course is a **** hits the fan your by yourself step by step approach to managing a trauma pt. obviously in most cases your going to have at least one other person with you doing everything simultaneously.

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Specializes in Med-Tele; ED; ICU.
Hey guys I just took tncc last month and it was really stressed to us that the course is a **** hits the fan your by yourself step by step approach to managing a trauma pt. obviously in most cases your going to have at least one other person with you doing everything simultaneously.

Generally, yeah.

Though I have been the only nurse in the room when the only doc was a trauma intern because we had multiple critical patients show up in a short period of time.

It's the exceptional cases that make you or break you, docs and nurses alike.

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