TNCC Scenarios

Dacatster, ADN · Aug 20, 2021

It has been a while since I was TNCC certified, but what I can remember the scenerio were either the same or very close to what is in the book

chare · Aug 20, 2021

I don't know that practicing random scenarios at home would necessarily be helpful. When you consider the distinct patient populations (pediatric, pregnant, bariatric, thoracic penetrating trauma, and head injury) the trauma nursing process (TNP) is the same, what you should consider is what is unique about managing these patient populations (e.g., placing pregnant patient left side down).

What I would suggest would be to learn the TNP. You should have received both the 8th edition provider course TNP for students and one page TNP reference; if not contact your course coordinator. Start with the one page TNP reference and memorize the major headers (I.e., airway, breathing, circulation, disability, etc.) in order (and remember that the double starred items must be done in sequential order and failure to do so will likely result in failing the TNP station).

After you receive your scenario don't forget preparation and triage and/or the accross-the-room observation (failure to reprioritize CABCDE for uncontrolled hemorrhage could result in failure for double starred items out of sequence). The individual components of the primary survey (ABCEDFG) also have standards that must be met. For example, in airway and alertness you must maintain cervical spinal stabilization, determine a level of responsiveness using AVPU, and identify a minimum of 4 areas of assessment and/or intervention. And, upon completion of the primary survey you haven't already implement them, don't forget F and G (L, M, N, O, and P).

Then, move on to the secondary survey where you will obtain patient history and completed the head to toe survey. Remember, you are going to inspect and palpate, and you have to mention both. There is a mnemonic that was used in a pre-hospital trauma course several years ago that can help you remember what you are looking for: DCAP, BLS, TIC, PMS. These indicate:

DCAP: Deformities, contusions, abrasions, punctures, paradoxical motion
BLS: Burns, lacerations, swelling
TIC: Tenderness, instability, crepitus
PMS: Pulses, motor, senstation

And, when you've gotten to here, don't forget to inspect the posterior surfaces, unless contraindicated. As you wrap up your scenario, you will be asked to list at least three interventions (include interventions you've already mentioned, such as labs, imaging, splinting, etc). Also think of things that need to be reevaluated (ABCs, abnormal labs, response to any intervention that you've applied). And lastly, a definitive care or transport determination.

The last suggestion, when you start your TNP, start talking and don't stop. Tell the evaluator everything.

Best wishes.