TNCC 7th Edition is a Soup Sandwich!

SummitRN, BSN, RN · Jun 3, 2014

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!

Interesting... anyone else have more thoughts on this? Considering courses at the moment.

Guests · Jun 3, 2014

Interesting... anyone else have more thoughts on this? Considering courses at the moment.

I've taken both and ATCN is the better of the two. Why? Because it's created and taught collaboratively between the Society of Trauma Nurses and the American College of Surgeons.

The book is the identical book being used by the docs taking ATLS and, at least in our case, the lectures are presented by doctors, not nurses.

It is simply a better class.

{Though most trauma patients don't need Foleys}

Editorial Team / Moderator · Jun 3, 2014

{Though most trauma patients don't need Foleys}

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.

That Guy, BSN, RN, EMT-B · Jun 3, 2014

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.

Same here.

CraigB-RN, MSN, RN · Jun 4, 2014

The answer to that is probably going to be the definition of a trauma patient. Is a trauma patient, every patient that comes into the trauma bay or ED after having a accident. No. In TRAUMA patients, the multisystem or sick patients. yes. The majority by number of patients who hit the bay probably don't need foleys.

Editorial Team / Moderator · Jun 4, 2014

In TRAUMA patients, the multisystem or sick patients. yes. The majority by number of patients who hit the bay probably don't need foleys.

Yes, I meant TRAUMA, not trauma. Lol. Pts that are legit traumas, not just occupying a trauma bay. I guess it depends on where you are.

Guests · Jun 4, 2014

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.

I read the rest of the thread before replying (the app works great for reading but my 10-finger-typing is soooo much faster than my 2-thumb typing)...

I would agree with your trauma vs Trauma vs TRAUMA distinction.

Generally speaking, we're really trying to limit Foleys for obvious reasons...

+ traumas... rarely

+ Traumas... occasionally

+ TRAUMAS... always

How's that?

Generally, particularly for men, if they're GCS 15 and without serious concern for spinal injury (clear w/ collar) or moderate-to-severe shock, no Foley because a urometer is overkill and we can accurately track output with a urinal.

This typically includes the extremity traumas, a lot of the chest stabbings, and the stable GSWs.

In the broad spectrum of trauma activations from barely-a-trauma to barely-alive, I'd still say that "most" traumas don't need Foleys. I find a fair number get ordered simply because it's part of the order set and that the docs often rescind when questioned.

Editorial Team / Moderator · Jun 4, 2014

Generally speaking, we're really trying to limit Foleys for obvious reasons...
+ traumas... rarely
+ Traumas... occasionally
+ TRAUMAS... always

Makes complete sense. Thank you for clarifying. Many of our patients in Afghanistan were TRAUMAS, but here, not so much ... Level I drama center some days. lol.

CraigB-RN, MSN, RN · Jun 4, 2014

Another thing to keep in mind, the target audience.

Alphabet soup courses really aren't geared toward people who have focused practices like trauma. This includes ACLS when you work in bigger teaching hospitals were they don't follow ACLS, but are heading out into uncharted territory. Look at how long it takes to make change.

Now for nursing staff in lower acuity ED then classes like TNCC are useful. They aren't perfect, but they cover the basics. When choosing courses to go to, take into account your personal skill and knowledge level, and the specific practice your in.

When I did my last TNCC recent, last year, i sat on my hands and almost bit my tongue off keeping my mouth shut because I knew some of the changes that were coming.

And to keep it in perspective. Go follow some of the Trauma Docs, and they make just as many comments about the new ATLS book as we make about the new TNCC course every time.

Esme12, ASN, BSN, RN · Jun 5, 2014

+ traumas... rarely
+ Traumas... occasionally
+ TRAUMAS... always

LOVE THIS!

bgxyrnf, MSN, RN · Apr 27, 2016

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.