Friday, July 25, 2008

TNCC

For all you folks that don't know, TNCC stands for Trauma Nursing Core Course. It's mandatory for all of the nurses in my unit. It's not that hard, but it is kind of a cool reminder of what kind of stuff to focus our assessments on with fresh traumas. I guess it doesn't hurt to have a TNCC mindset with old traumas either. I can proudly say that because of a trauma nursing course I took a couple of years ago, I set my assessments up according to the primary assessment as laid out in TNCC. Here is the basic outline of TNCC:

Get report from the medics, maintain C-Spine immobilization, and then:

PRIMARY ASSESSMENT (VERY IMPORTANT, ASSESS & FIX):

Airway- consider adjuncts such as oral/endotracheal tubes if needed
Breathing- check rate, pattern, bilateral chest rise, skin color, acessory muscles, etc.
Circulation- pulses, bleeding, IVs, cap refill, JVD, etc.
Disability (Neuro)- Level of consciousness, pupils
Expose/Environment- Remove clothing and check for problems, make a safe environment

Secondary Assessment:

Full Vital Signs/Five Interventions (pulse ox, EKG, foley, NG, labs)/ Family
Give comfort
History/ Head to Toe assessment
Inspect Posterior / Injuries

Provide/suggest follow-up diagnostics and interventions such as consults, imaging, or labs

Prepare for OR, Admission, or Transfer

It's good stuff. A, B, C, D, E, F, G, H, I




IN OTHER NEWS:

I like MySpace a lot. I don't know why, but it seems like it's much more libertarian than Facebook's rigid layout. Facebook is creepy.

I'm not sure if I want to be a nurse practitioner. I'd make (a little) more money and have more authority and better hours, but my work wouldn't be nearly as cool (Surgical/Trauma ICU vs. Family Practice Office). I guess it's a career, not a hobby; it's not about what's cool or fun... It's actually a really complex issue since NP's have a really weird niche with lots of possiblilities (good and bad).

I'm sleepy.

I'm watching the little sib's this weekend. Good times.

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