Welcome and Initial Assessment Notice of Disclosures Program

Welcome and Initial Assessment

Notice of Disclosures • Program title • Trauma Nursing Core Course • 8 th Edition Provider Course • Program purpose • Improve trauma patient outcomes by providing nurses with foundational trauma knowledge, skills, and a systematic Trauma Nursing Process (TNP) to guide trauma patient care • After taking TNCC, nurses will be able to systematically assess the trauma patient, intervene and/or assist with interventions, and provide evidence-based trauma nursing care within the context of a trauma team

Requirements for Successful Completion • Completion of online modules • Attendance during the entire educational session • Successful performance of psychomotor skills with a minimum score of 70% (2 attempts) • Successful completion of the online examination with a minimum score of 80% (2 attempts) • Completion and submission of the online course evaluation After successful course completion, RN participants are verified as TNCC providers for 4 years Continuing nursing education certificates will be provided to all participants who complete the course Certificates and cards may be reprinted from www. ena. org

Planning Committee Conflict of Interest Disclosure Ron Kraus, MSN, RN, CNS, EMT-B, CEN, ACNS-BC, has been a speaker for Posey/TIDI There are no conflicts of interest to disclose for the following planning committee members: • Joseph S. Blansfield, MS, NP, TCRN • Melanie Crowley, MSN, RN, CEN • Paula L. Davis, MSN, ARNP, CEN, CPEN, CFRN, FNP-BC • Margaret M. Mc. Neill, Ph. D, RN, APRN-CNS, CCRN-K, CCNS, TCRN, CPAN, NE-BC, NHDP-BC, FAAN • Kellyn M. Pak, MSN, RN, CEN, TCRN, MICN • Janis Farnholtz Provinse, MS, BSN, RN, CNS, CEN, TCRN, FAEN • Sheila Silva, DNP, RN, CEN, TCRN • Angela M. Westergard, MSN, MBA, RN, CEN

Disclosure of Conflicts of Interest • There is no conflict of interest to disclose for the Course Director • Course Director Name: • There are no conflicts of interest to disclose for the Instructors • Instructor Names: Note to Course Director: Fill in the names of the Course Director and Instructors here. If there ARE conflicts of interest, they must be identified on this slide after a resolution by ENA staff. A copy of this slide with the course # is to be emailed to ENA Course Operations ONLY if a conflict of interest is identified.

Commercial Support/Non-endorsement • Commercial support: None Note to Course Director: If there is commercial support, it must be identified here. Commercial support includes monetary and in-kind support such as the loan of equipment. A commercial support agreement must be submitted to CNE@ena. org in advance for review and approval. • Non-endorsement of product The Emergency Nurses Association’s accredited Provider Unit does not imply endorsement by ENA of any commercial products discussed/displayed in conjunction with this educational activity

Emergency Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Emergency Nurses Association is approved by the California Board of Registered Nursing, Provider #2322.

Essentials and Next Steps • Participation • This is a safe place to make mistakes! • Take turns being the group spokesperson • If this is REALLY uncomfortable, let your group and the course director know • EACH student will practice leading at least 1 TNP scenario • After you complete the TNP test, you will receive a link to the online exam • Use the email you used to access the online modules • Exam deadline is 7 days for both attempts • Must be completed in one sitting in less than 2 hours • At 2 hours, the exam will be graded • If you close your browser, the exam will be graded • Save the provided Agenda With Evaluation Information to complete the course and instructor evaluation

Introductions and Online Module Review • What is your name? • Where do you work? • Have you taken TNCC before? • Each group Share one thing you remember from the online modules that you think EVERY trauma nurse needs to know NO REPEATS! • Biomechanics • Chapter 2, page 9 • Initial Assessment • Chapter 3, page 25 • Pediatric • Chapter 12, page 231 • Geriatric • Chapter 13, 261 • Bariatric • Chapter 14, page 279 • Pregnant • Chapter 15, page 293 • Interpersonal Violence • Chapter 16, page 301

Chapter 2: Biomechanics • Mechanism of injury • Motor vehicle impact sequence • Kinetic energy • Effects of energy on the human body

Chapter 12: The Pediatric Trauma Patient • Pediatric assessment triangle • Capillary refill time • Compare central and peripheral pulses • Minimum BP • 70 + (2 x age) • Hypotension is a LATE sign • Weight in kilograms • Length-based resuscitation tape • Fluid bolus • 20 m. L/kg crystalloids • 10 m. L/kg PRBC • More to come in the TNP…

Chapter 13: The Geriatric Trauma Patient • Mechanism of injury • Comorbidities • Minor trauma can have major impact • Polypharmacy • Do not rely on tachycardia as a sign of shock • Consider reversal agents • Skin breakdown risk

Chapter 14: The Bariatric Trauma Patient • Positioning • Equipment • Diagnostics • Lifting help • Gastric tubes? • Nursing care • Sensitivity • Dignity Ramped position for intubation

Chapter 15: The Pregnant Trauma Patient • Supine hypotension syndrome • Tilt mother to either side or manually displace uterus • Prioritize care of mother to best support baby • Normal fetal heart rate • 120– 160 • May be heard by 10 weeks • More to come in the TNP…

Chapter 16: Interpersonal Violence • Red flags • Human trafficking • Mandated reporter • Resources for interpersonal violence • Approach to the IPV survivor

Online Module Availability • You are welcome to review all of the online modules at your leisure • They will be accessible in your online learning plan at www. ena. org for 4 years

On with the Class! • Work with your group • Place the cards in the correct order according to the Trauma Nursing Process • Not EVERY step is included • In 10 minutes, each group will share the ** and * criteria • We will review the TNP in GREAT detail throughout the class

Time Left for Group Activity 10 Minutes

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e l g n i S d n a e l b u o D d e r r Sta a i r e t Cri ay w r i A d on i n t a a l s i s t e n n e t V r d n a • Ale g in h t a • Bre ation l u c r i t • C n e y t i m n bil o r a i s i v En • D / e r su o p x • E ry a m i pr f o t n s e n m o s i s t se erven s n a o i e t t R a • er y in t l e a v r ny y su a f i CT isabilit n d a a e g D H n • si in u d t e no m s s se le s s a a e c s c n a i e f a t ur s • P ropria r o eri cated) t s app o s p raindi t c e • Inspless cont (un

Trauma Nursing Process (TNP) • Preparation and Triage • Primary survey (A-E) with corresponding intervention as required (F-G) • Reevaluation • Secondary Survey (H-I) • Reevaluation (J) and Post-Resuscitation Care • Definitive Care or Transfer

Benefits of the Trauma Nursing Process • Systematic approach to the evaluation of each trauma patient • Identifies life-threatening conditions • Determines priorities of care