Trauma Nursing Core Course (TNCC)

Trauma Nursing Core Course (TNCC) Dr. Aidah Abu El Soud Alkaissi Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

Philosophy • The magnitude (the property of relative size or extent (whether large or small) of trauma as a national and international problem is documented by data that identifies injury as being the primary cause of death in persons under age 45. • The optimal care of the trauma patient is best accomplished within a framework in which all members of the trauma team use a systematic, standardized approach to the care of the injured patient. Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

Philosophy • Emergency nurses are essential members of the trauma team. Morbidity and mortality of trauma patients can be significantly reduced by educating nurses to provide competent trauma care. • The Emergency Nurses Association (ENA) and its constituents (someone who can or does appoint or elect) have the responsibility to facilitate trauma-related, continuing education opportunities for nurses who provide care to trauma patients. Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

Purpose • Trauma nursing as a discipline refers to the process and content of all the different roles nurses have in the care of the trauma patient. • Knowledge is the core of any discipline. • Reduction in trauma morbidity and mortality is an international goal • The purpose of TNCC is to present core (the center of an object) -level knowledge, refine (fined -fining ) skills, and build a firm foundation in trauma nursing. Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

Trauma Nursing Core Course (TNCC) • ENA developed and implemented the TNCC for national and international dissemination (The passing out or spreading about of something) as a means of identifying a standardized body of trauma nursing knowledge. • The TNCC (Provider) is a course designed to provide the learner with cognitive knowledge and psychomotor skills. • Nurses with limited emergency nursing clinical experience, who work in a hospital with limited access to trauma patients, or who need greater time at the psychomotor skill stations are encouraged to attend courses Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

Epidemiology of truama • Death is known to occur at three key interval/peaks • First: within minutes of the injury • Second: within 2 h after injury • Third: weeks after the incident often due to complications Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

Epidemiology of truama • The need to address the rising accident rates and costs to the individual and society • There has been in research and community based projects to educate the public in safety/prevention, first aid and immediate life support Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

Mechanism of injury/Biomechanics • Mechanisms of injury are based on kinematics Which is the process of evaluating the probability of injuries based on: • Forces and motion involved in the trauma • Accident information gleaned (To collect (information, etc) bit by bit) at the time of intial assessment • A high index of suspicion by the practitioner for injuries Index (a numerical scale used to compare variables with one another or with some reference number, A statistical indicator providing a representation of the value of the securities which constitute it. Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

Mechanism of injury/Biomechanics • Newton´s first law of motion is most frequently cited: • ” a body at rest will remain at rest, and a body in motion will remian in motion until acted on by an outside force” Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

Mechanism of injury/Biomechanics • The extent of injury is based on two factors: • The a mount/magnitude (the property of relative size or extent ) of energy, speed or velocity (speed: distance travelled per unit time) • The duration of impact (any effect caused by a proposed activity on the environment) • The human body will absorb energy, and injury will occur when the tissue limits fail Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

The factors influencing injury • Tensile strength-the amount of tension a tissue can withstand and the ability to resist stretching forces • Elasticity-ability to resume the original size and shape after being stretched • Compressive strength- ability to resist squeezing forces or inward pressure • Acceleration-change in rate or speed of a moving body • Shearing (removing by cutting off or clipping) force- occur a cross a plane (A surface containing all the straight lines that connect any two points on it) with structures slipping relative to each other Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

The factors influencing injury • Information gained at the scene of the incident is invaluable when treating the patient in the emergency department Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

The type of injury that results can be identified as • 1. Non-penetrating/blunt- an injury with no commuincation to the outside environment • Is potentially life threatening as the extent of injury is less obvious, often making diagnosis more difficult • The forces are acceleration (Increase in speed or change of direction), deceleration (decreasing the speed) , compression • The common causes are motor vehicle crashes, falls, assaults (the crime of violence against another person) and contact sport Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

The type of injury that results can be identified as • Penetrating injuries- are caused when an outside or foreign object is set into motion • The extent of the injury is dependent upon knowing: • The type and characteristic of object/agent • Energy dissipation (A wave that loses amplitude (low velocity or high velocity) • Tissue characteristics (dense/loose) • Distance from the weapon to individual target • The common causes are stab wounds, gunshot wounds Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

The type of injury that results can be identified as • Other injuries-explosive blasts occur when detonated (To cause to explode) explosives are converted to large volumes of gases, causes fragments to become- high –velocity missiles, and the blast (A forcible stream of air, gas, or steam from an opening) shock wave to cause damage at air- tissue contacts Dr. Aidah Abu El Soud Alkaissi Intensive Care and Anaesthesia Department Linköping University Sweden

Trauma Nursing Core Course (TNCC)