TNCC Certification

Nearly all of our interfacility trauma transfers, both adult and pediatric, are taken directly to the ICU. If the patient arrives from the scene, they are initially seen in the ED, but the goal is to get them out or the ED and to the OR or ICU as quickly as possible.

Well that makes complete sense for inter-facility transfers because the initial stabilization (which is the gist of TNCC) should have been done by the sending hospital and that's the process I am familiar with. What I'm not familiar with is bypassing the ED entirely (as postulated by a previous poster) and taking a scene patient directly to the ICU. Having worked at both pediatric and adult level one centers we completed as much diagnostic evaluation as possible (X-ray, CT, Bedside US etc) prior to moving the patient to the unit/OR so that the receiving units could prepare for what they actually were receiving injury wise. Usually that meant going from the ED to the scanner then directly to the unit to save as much time as possible and so the unit didn't have to bring the patient back down for scans. I am unfamiliar with any hospitals in my area that do the initial stabilization in the ICU.

As far as TNCC I see value in it for the staff in all areas of trauma. Even if you don't do the initial stabilization it's always good to know what transpired prior to admission plus there is a lot of good additional information in it that impacts the care of the trauma patient along the continuum.

The American College of Surgeons is who sets the standards by which hospitals are categorized by level. They are the ones who do the site visits. Having been closely involved in a site visit I can tell you that they dictate just about everything including where each staff member is positioned around the gurney. It's as stressful as a Commission visit and just as much work.