Trauma Nurse Core Course (TNCC) Practice Exam

What is the highest priority intervention for a 2-year-old who fell from a 2nd story window and is in respiratory distress?

1. Padding the upper back while stabilizing the cervical spine

2. Applying a tight-fitting NRB mask with an attached reservoir

3. Establishing intravenous access and administering a 20mL/kg bolus

4. Preparing for drug-assisted intubation

The correct answer is: Padding the upper back while stabilizing the cervical spine

In the case of a 2-year-old who has fallen from a height and is experiencing respiratory distress, the highest priority intervention focuses on ensuring adequate airway management while maintaining cervical spine stabilization due to the significant risk of spinal injuries from such a fall. Padding the upper back while stabilizing the cervical spine is crucial because it protects the child's airway and cervical spine from any further injury that might occur with movement. Children at this age may be at a higher risk for complications if their cervical spine is not properly stabilized, especially in trauma cases. While airway management is necessary, the immediate concern involves ensuring that there is no further risk of spinal cord damage, which could be exacerbated by improper handling. Maintaining spinal stability assures that the child’s condition won't worsen due to potential vertebral or cord injuries, which are paramount in any trauma assessment. This approach lays a foundation for subsequent interventions like airway management or fluid resuscitation.