FREE TCRN Study Guide 2026: A Complete, BCEN-Aligned Walkthrough

This free TCRN study guide walks through the highest-yield content the BCEN Trauma Certified Registered Nurse exam tests, organized by the six official content areas of the BCEN content outline — from head-to-toe clinical trauma through the full continuum of care and professional practice.^[2]

It is interactive, not a wall of text: every content area has worked clinical scenarios, comparison tables, labeled diagrams, and built-in flashcards, taught the way the TCRN actually tests trauma — recognizing life threats, prioritizing with the primary survey, and managing injuries across resuscitation, definitive care, and recovery.

Read it content area by content area, then round out your prep with our practice questions and flashcards. The TCRN validates the knowledge a registered nurse needs to care for trauma patients across the full continuum of care.

TCRN Exam Snapshot

The exam is built almost entirely from clinical trauma care: Clinical Practice: Trunk and Pelvis (38 questions) and Continuum of Care for Trauma (36) together are about half the exam, followed by Head and Neck (31). Budget your study toward the heaviest content areas first.^[2]

Percentages are rounded from the official scored-item counts in BCEN’s TCRN content outline effective November 2025; the three Clinical Practice areas are grouped by body region rather than by organ system.^[2]

How the TCRN Is Built: the Trauma Continuum

The TCRN is organized around the trauma continuum of care — the idea that a trauma patient moves through a predictable sequence (injury → field care → resuscitation → definitive care → rehabilitation → reintegration), and the trauma nurse must think across all of it. Three content areas test clinical care by body region (Head and Neck; Trunk and Pelvis; Musculoskeletal and Wound), one tests it by population (Special Populations), one tests the process of care (Continuum of Care), and one tests the system around it (Professional Practice).^[2]

The single most important framework for the whole exam is the primary survey. Trauma care is relentlessly prioritized: you address the fastest killer first and re-check from the top whenever the patient changes. Learn this sequence cold and most of the clinical content areas become applications of it.

After the primary survey and resuscitation come the secondary survey (a head-to-toe exam and an AMPLE history) and definitive management. Throughout, the trauma nurse watches for the deterioration that defines trauma — occult hemorrhage, rising intracranial pressure, and the self-reinforcing trauma triad of death.

Clinical Practice: Head and Neck

Head and Neck is the third-largest content area at 31 scored questions.^[2] It is dominated by traumatic brain injury and the recognition of rising intracranial pressure, plus spinal cord injury, and the maxillofacial, ocular, and neck injuries that threaten the airway. The recurring theme is preventing secondary brain and cord injury — hypoxia, hypotension, and hyperthermia all worsen outcomes.

Traumatic Brain Injury & the GCS

Traumatic brain injury is graded by the Glasgow Coma Scale: mild (13–15), moderate (9–12), and severe (8 or below). The GCS sums eye opening (1–4), verbal response (1–5), and best motor response (1–6), so the lowest possible score is 3 — there is no zero. Distinguish the primary injury (the mechanical damage at impact, which cannot be undone) from secondary injury (the cascade of hypoxia, hypotension, edema, and rising pressure that nursing care can prevent).^[6]

Concussion is a mild TBI; the danger is missing a deteriorating bleed. A patient who “talks and dies” — lucid, then declining — is the classic epidural hematoma. Protect the airway in any patient with a GCS of 8 or below, keep oxygenation and blood pressure up to protect cerebral perfusion, and trend the GCS frequently; a falling score is the alarm.

Intracranial Hemorrhage & Rising ICP

Know the three traumatic bleeds on sight. An epidural hematoma is arterial (the middle meningeal artery), biconvex on CT, and does not cross sutures; a subdural hematoma is a slower venous bleed, crescent-shaped, crossing sutures, and common in older or anticoagulated patients; a subarachnoid hemorrhage fills the sulci and causes the worst headache of life.

Intracranial pressure is normally 5–15 mmHg; sustained elevation collapses cerebral perfusion (CPP = MAP − ICP). Late, ominous signs are a declining level of consciousness and Cushing’s triad (hypertension with a widening pulse pressure, bradycardia, irregular respirations). Manage rising ICP with the head of bed at 30°, the head midline, normocapnia, normothermia, hypertonic saline or mannitol, and avoidance of hypoxia and hypotension.^[4]

Spinal Cord Injury & Neurogenic Shock

Maintain full spinal precautions until the spine is cleared. Distinguish neurogenic shock (a hemodynamic problem: hypotension WITH bradycardia and warm, dry skin from lost sympathetic tone after a high injury) from spinal shock (a neurologic problem: temporary loss of all reflexes and function below the lesion that resolves). Treat neurogenic shock with fluids, vasopressors, and atropine for symptomatic bradycardia — and remember that a trauma patient’s hypotension is hemorrhage until proven otherwise, so rule out bleeding first.

Later, injuries at or above T6 risk autonomic dysreflexia — a hypertensive crisis with pounding headache and flushing triggered by a stimulus below the lesion (most often a distended bladder). Sit the patient upright, loosen constrictions, and find and remove the trigger immediately.

Maxillofacial, Ocular & Neck Trauma

Maxillofacial trauma threatens the airwayfirst — blood, broken teeth, edema, and Le Fort fractures can obstruct rapidly; be ready for a difficult airway and watch for a basilar skull fracture (raccoon eyes, Battle’s sign, CSF rhinorrhea or otorrhea — do not pack the nose or place a nasogastric/nasal tube).

Ocular emergencies include a ruptured globe (shield it, do not press), chemical burns (immediate copious irrigation), and a retrobulbar hematoma. Penetrating neck trauma risks the airway and vascular structures; never probe the wound, and watch for an expanding hematoma, bruit, or subcutaneous emphysema.

Clinical Practice: Trunk and Pelvis

Trunk and Pelvis is the largest content area at 38 scored questions.^[2] It is where the immediately life-threatening chest injuries live, plus the occult abdominal and pelvic bleeding that quietly drives a trauma patient into shock. Master the chest emergencies you find on the primary survey and the occult-hemorrhage sources you hunt for on the secondary survey, and you own the single biggest block of the exam.

Thoracic Trauma

A tension pneumothorax is a clinical diagnosis — severe distress, absent breath sounds and hyperresonance on the affected side, hypotension, JVD, and late tracheal deviation away from the injury — treated with immediate needle decompression then a chest tube; do not wait for a film. A massive hemothorax (more than ~1,500 mL of initial chest-tube output, or ongoing brisk drainage) needs a chest tube and surgery. Cardiac tamponade from penetrating chest trauma shows Beck’s triad (hypotension, JVD, muffled heart sounds) plus pulsus paradoxus.

Flail chest (three or more adjacent ribs each broken in two or more places) causes paradoxical movement and, more importantly, an underlying pulmonary contusionthat can worsen over 24–48 hours — support oxygenation and ventilation and give good analgesia. Suspect a blunt aortic injury after high-speed deceleration (a widened mediastinum on imaging): control heart rate and blood pressure tightly to limit shear while awaiting repair.

Abdominal & Solid-Organ Injury

The abdomen is the great hider of occult hemorrhage. The spleen is the most commonly injured solid organ in blunt trauma, followed by the liver; suspect splenic injury with left-upper-quadrant pain and Kehr’s sign (referred left shoulder pain).

A bedside FAST exam screens for free fluid in four windows; a positive FAST in an unstablepatient means the operating room, while a stable patient may go to CT. Many stable solid-organ injuries are managed non-operatively with serial exams, serial hematocrits, and bed rest — so the nurse’s job is vigilant reassessment for a failing nonoperative course.^[9]

Hollow-organ injury (bowel, bladder) and pancreatic or duodenal injury can present late with peritonitis or sepsis. A seat-belt sign or handlebar mark is a red flag for underlying bowel and mesenteric injury even when the patient looks well early.

Pelvic & Genitourinary Trauma

An unstable pelvic fracture can exsanguinate into the retroperitoneum. Do notrock or repeatedly “spring” the pelvis; apply a pelvic binder at the level of the greater trochanters to reduce pelvic volume and tamponade venous bleeding, then resuscitate and arrange angioembolization or external fixation. Genitourinary injury clues include gross hematuria, a high-riding prostate, and blood at the urethral meatus or scrotal/perineal bruising — these contraindicate urinary catheter placement until a urethral injury is excluded.

Spinal Column & Vertebral Injury

Vertebral column injuries (the bony spine) are distinct from the cord injuries covered under Head and Neck, but the precautions overlap: maintain spinal motion restriction, log-roll for movement and skin checks, and image per validated criteria (such as NEXUS or the Canadian C-spine rule). Unstable thoracolumbar fractures threaten the cord; assess and document a baseline neurologic exam and watch for any change. Prevent the complications of immobility — pressure injury, VTE, and ileus.

Clinical Practice: Musculoskeletal and Wound

Musculoskeletal and Wound is a smaller content area at 13 scored questions, but it carries several can’t-miss emergencies — limb-threatening compartment syndrome, life-threatening burns, and the systemic complications of fractures and crush injury.^[2]

Fractures & Compartment Syndrome

For any fracture, assess neurovascular status (the 5 P’s pulses, then sensation and motor) before and after splinting, and splint to immobilize the joint above and below. An open fracture needs early antibiotics, tetanus prophylaxis, and a sterile dressing.

The limb-threatening emergency is compartment syndrome: rising pressure in a closed compartment, recognized by the 6 P’s — pain out of proportion and on passive stretch is the earliest sign, with pulselessness and paralysis late. Treatment is emergent fasciotomy; do not elevate above the heart or apply ice, and remove any constricting cast or dressing.

Long-bone and pelvic fractures also cause systemic problems: fat embolism syndrome (hypoxia, confusion, and a petechial rash 24–72 hours after injury) and, after a crush injury, rhabdomyolysis (elevated CK, dark tea-colored urine) that threatens the kidneys and is treated with aggressive IV fluids.

Burns & Fluid Resuscitation

In a major burn, the first priority is still the airway: suspect inhalation injury with facial burns, singed nasal hairs, soot in the mouth, hoarseness, or stridor — and intubate early before airway edema closes it. Estimate burn size with the Rule of Nines (counting only partial- and full-thickness burns) and calculate fluids with the Parkland formula.

Use warmed lactated Ringer’s, titrate to a urine output of about 0.5 mL/kg/hr, watch for carbon-monoxide and cyanide toxicity in enclosed-space fires (a normal SpO₂ can be falsely reassuring in CO poisoning — treat with high-flow oxygen), and remove constricting circumferential burns that can require escharotomy. Keep the patient warm — burn patients lose heat fast.

Wounds & Soft-Tissue Injury

Control external bleeding with direct pressure, then a tourniquet for life-threatening extremity hemorrhage (note the time applied). Irrigate and assess wounds for depth, foreign bodies, and neurovascular or tendon involvement; update tetanus prophylaxis based on wound type and immunization history.

Do not remove an impaled object in the field or ED — stabilize it in place, because it may be tamponading a vessel. Watch traumatic and surgical wounds for infection and the rare but rapidly fatal necrotizing soft-tissue infection (pain out of proportion, crepitus, systemic toxicity), which is a surgical emergency.

Special Populations

Special Populations is 22 scored questions and tests how trauma differs by patient group — pediatric, geriatric, obstetric, and bariatric.^[2] The unifying lesson is that the same injury behaves differently, and the “normal” vital signs and assessment shortcuts you rely on can mislead you.

Pediatric Trauma

Children have tremendous reserve and maintain blood pressure until they have lost a large volume, so hypotension is a very late, ominous sign — tachycardia is the earliest reliable indicator of shock.

A larger head-to-body ratio raises head-injury risk; a compliant rib cage transmits force to organs without obvious external injury (significant pulmonary or solid-organ injury with few external marks). Use weight-based dosing and a length-based resuscitation tape, keep the child warm (high surface-area-to-mass ratio), and recognize injury patterns inconsistent with the reported mechanism or developmental stage as red flags for non-accidental trauma, which is mandatory to report.

Geriatric Trauma

Older adults deteriorate from seemingly minor mechanisms (a ground-level fall) because of reduced reserve, anticoagulation, and blunted compensation.^[7] Beta-blockers can mask the tachycardia of shock, and a “normal” blood pressure may be relative hypotension in a chronically hypertensive patient — so undertriage is common and dangerous.

Anticoagulation greatly raises the risk of intracranial bleeding after even minor head trauma. Have a low threshold for trauma-team activation, CT imaging, and serial reassessment, and screen for the polypharmacy, osteoporosis, and frailty that shape both the injury and the recovery.

Obstetric Trauma

The best treatment for the fetus is aggressive resuscitation of the mother. After ~20 weeks, relieve aortocaval compression with left lateral tilt or manual uterine displacement. A pregnant patient can lose 30–35% of blood volume before showing shock signs, so the fetus may be compromised while the mother still looks stable.

Monitor the fetus and watch for placental abruption (abdominal pain, vaginal bleeding, uterine tenderness or contractions) after even minor abdominal trauma. A perimortem cesarean delivery is considered within about 4 minutes of maternal cardiac arrest after roughly 20–24 weeks to improve survival.

Bariatric & Substance-Related Trauma

Patients with obesity present airway, ventilation, imaging, dosing, and equipment challenges, and are prone to rapid desaturation, difficult vascular access, and pressure injury — plan for appropriate equipment and positioning early. Alcohol and substance intoxication confounds the trauma exam (a depressed GCS may be drugs or a brain injury — assume injury and image), masks pain, and complicates resuscitation; anticipate withdrawal during the hospital stay and screen and intervene for substance use as part of injury prevention.

Continuum of Care for Trauma

Continuum of Care is the second-largest content area at 36 scored questions.^[2] It is the process backbone of trauma care: the mechanism of injury, the primary and secondary surveys, the recognition and treatment of shock, hemorrhage control and massive transfusion, and the patient’s movement through transport, definitive care, rehabilitation, and end-of-life care.

Mechanism of Injury & the Surveys

Mechanism of injury predicts the injury pattern: blunt trauma (MVCs, falls, assaults) transfers energy over a wide area and causes internal and deceleration injuries, while penetrating trauma (stabbings, gunshots) injures along the path and energy of the object.

High-energy mechanisms (ejection, death of another occupant, a fall over ~20 feet, high-speed deceleration) raise suspicion for occult injury. Run the primary survey (X-A-B-C-D-E), treat life threats as found, then the secondary survey (head-to-toe plus an AMPLE history) — and reassess from the top after every intervention or deterioration.

Shock & Hemorrhage Control

In trauma, hypotension is hemorrhage until proven otherwise. Grade hemorrhagic shock by the ATLS classes, remembering that tachycardia and a narrowing pulse pressure come early and hypotension comes late.

But not all shock in trauma is hemorrhagic — distinguish the four states so you treat the right cause.

Control bleeding in a stepwise way: direct pressure → tourniquet or hemostatic dressing for the limbs → pelvic binder for the pelvis → operative or angiographic control for internal hemorrhage. Give tranexamic acid early (ideally within 3 hours) for significant hemorrhage.

Resuscitation & Massive Transfusion

Modern trauma resuscitation is blood, not crystalloid: large volumes of saline dilute clotting factors, drop the temperature, and feed the trauma triad of death (hypothermia, acidosis, coagulopathy). Activate the massive transfusion protocol for the exsanguinating patient, giving a balanced 1:1:1 ratio of packed red cells, plasma, and platelets.^[5]

Use permissive hypotension (a lower blood-pressure target until surgical control) in selected patients without traumatic brain injury, where adequate cerebral perfusion must be maintained. The BCEN outline names the updated “trauma diamond of death” — the classic triad plus hypocalcemia, so replace calcium during massive transfusion (citrate binds it), keep the patient and all products warm, and watch for the transfusion complications TACO (circulatory overload) and TRALI (transfusion-related acute lung injury). Support damage-control resuscitation toward definitive surgical source control.

Transport, Rehabilitation & End-of-Life

The continuum continues beyond the resuscitation bay. Trauma triage and interfacility transfer match the patient to the right level of trauma center, and safe transport requires anticipating deterioration (secure the airway and lines before moving) and the effects of altitude in flight.

Rehabilitation begins early — preventing the complications of immobility, supporting mobility and nutrition, and planning the transition to recovery. When injuries are non-survivable, the trauma nurse provides compassionate end-of-life and family care, supports organ and tissue donation per protocol, and attends to the patient’s and family’s psychosocial and spiritual needs.

Professional Practice

Professional Practice is the smallest content area at 10 scored questions, but it is easy points if you know the framework.^[2] It covers the trauma system around the patient: trauma systems and performance improvement, disaster preparedness and mass-casualty triage, injury prevention, and the ethical and legal duties of the trauma nurse.

Trauma Systems & Quality Improvement

Trauma centers are verified by level (Level I provides the most comprehensive care, with progressively fewer resources at Levels II–V), and an inclusive trauma system coordinates care from the field through rehabilitation. Performance improvement and patient safety (PIPS) programs use the trauma registry, audit filters, peer review, and morbidity-and-mortality conferences to measure outcomes and close care gaps — supporting a just culture of non-punitive error reporting.^[4] The trauma nurse contributes through accurate documentation, data collection, and participation in performance review.

Disaster Preparedness & Triage

In a mass-casualty incident the goal flips from doing the most for each patient to doing the most good for the most people.

START triage (Simple Triage And Rapid Treatment) sorts adults in under a minute using respirations, perfusion, and mental status into immediate (red), delayed (yellow), minor/walking-wounded (green), and expectant/deceased (black) — the only interventions during triage are opening an airway and controlling major bleeding. Know the basics of incident command, surge capacity, decontamination, and personal protective equipment for chemical, biological, radiological, and nuclear events.

Injury Prevention, Ethics & Legal

Most trauma is predictable and preventable, so injury prevention is core trauma nursing — primary (preventing the event: seat belts, helmets, fall-proofing), secondary (reducing severity: airbags, restraints), and tertiary (optimizing recovery and limiting disability).^[6]

Ethically and legally, the trauma nurse protects autonomy and informed consent, supports the patient who cannot consent in an emergency (implied consent), preserves forensic evidence (documenting wounds objectively, handling clothing and bullets carefully, maintaining chain of custody), recognizes and reports suspected abuse or neglect (a mandatory duty), and honors advance directives and organ-donation wishes.

Know the core regulations the outline names: EMTALA (the duty to screen, stabilize, and appropriately transfer regardless of ability to pay, which governs interfacility transfers), HIPAA privacy, and workplace-violence protections.

How to Use This Study Guide

Work through the guide one content area at a time. After each one, check it off in the contents to raise your exam-readiness score, then drill the same content in our free practice questions and flashcards — active recall and timed, domain-weighted practice are what move knowledge into exam-day performance.

• Weight your time by the blueprint. Trunk and Pelvis (38) and Continuum of Care (36) are about half the exam — start there, then Head and Neck (31).
• Anchor everything to the primary survey. Most clinical questions reward the X-A-B-C-D-E priority order — fix the highest life threat first.
• Memorize the high-yield emergencies. Tension pneumothorax, cardiac tamponade (Beck’s triad), hemorrhagic-shock classes, epidural vs subdural, compartment syndrome, and the Parkland formula appear again and again.
• Resuscitate with blood, not crystalloid. The 1:1:1 massive transfusion ratio, TXA, and breaking the trauma triad of death are central to the Continuum of Care.
• Don’t skip Special Populations or Professional Practice. Population differences and disaster/triage are reliable points if you know the patterns.

Common questions TCRN candidates search and get asked — each answered briefly and backed by an official source (BCEN, ACS/ATLS, CDC, NIH, or AAST). Tap any card to test yourself.

TCRN Glossary

Key TCRN terms in one place. Hover any dotted term throughout the guide for its definition; the full list is below.

TCRN

Trauma Certified Registered Nurse — the BCEN specialty certification validating the knowledge a registered nurse needs to care for trauma patients across the full continuum of care.

BCEN

Board of Certification for Emergency Nursing — the organization that owns and administers the TCRN, CEN, CPEN, and CFRN/CTRN credentials.

primary survey

The rapid, prioritized trauma assessment — X-A-B-C-D-E (exsanguinating hemorrhage, airway with C-spine, breathing, circulation, disability, exposure) — in which each life threat is treated as it is found.

secondary survey

The systematic head-to-toe assessment plus a full history (AMPLE) performed after the primary survey is complete and immediate life threats are addressed.

AMPLE

A trauma history mnemonic — Allergies, Medications, Past medical history, Last meal, Events/Environment of the injury.

mechanism of injury

How an injury occurred (blunt vs penetrating, energy transferred, speed, height), used to predict the pattern and severity of likely injuries.

GCS

Glasgow Coma Scale — a 3-to-15 score of consciousness across eye opening (1–4), verbal response (1–5), and best motor response (1–6); 8 or below is severe TBI.

TBI

Traumatic brain injury — a disruption of brain function from an external force; classified mild, moderate, or severe by GCS and graded by primary vs secondary injury.

epidural hematoma

An arterial bleed (usually the middle meningeal artery) that appears biconvex on CT, does not cross suture lines, and classically causes a lucid interval then rapid decline.

subdural hematoma

A venous bleed from bridging veins that appears crescent-shaped on CT, crosses suture lines, and is common in older or anticoagulated patients.

subarachnoid hemorrhage

Bleeding into the subarachnoid space, showing blood in the sulci and cisterns and presenting as the worst headache of life with nuchal rigidity.

ICP

Intracranial pressure — normally 5–15 mmHg; sustained elevation reduces cerebral perfusion and is a neurosurgical emergency.

Cushing's triad

A late, ominous sign of raised intracranial pressure: hypertension with a widening pulse pressure, bradycardia, and irregular respirations.

cerebral perfusion pressure

CPP = mean arterial pressure − intracranial pressure; the net pressure perfusing the brain, kept adequate to prevent secondary ischemic injury.

neurogenic shock

Distributive shock after a high spinal cord injury — loss of sympathetic tone causes hypotension WITH bradycardia and warm, dry skin.

spinal shock

A temporary loss of all reflexes, motor function, and sensation below a spinal cord injury that gradually resolves; distinct from neurogenic shock.

autonomic dysreflexia

A dangerous hypertensive crisis in injuries at or above T6, triggered by a stimulus below the lesion (often a full bladder); sit the patient up and remove the trigger.

tension pneumothorax

Air trapped under pressure in the pleural space causing absent breath sounds, hypotension, JVD, and late tracheal deviation; treated with immediate needle decompression then a chest tube.

hemothorax

Blood in the pleural space; a massive hemothorax (>1,500 mL initial output or ongoing brisk drainage) needs a chest tube and surgical evaluation.

flail chest

Three or more adjacent ribs each fractured in two or more places, producing a free segment with paradoxical chest movement and an underlying pulmonary contusion.

cardiac tamponade

Blood or fluid in the pericardial sac compressing the heart; recognized by Beck's triad and treated with pericardiocentesis or thoracotomy.

Beck's triad

The three classic signs of cardiac tamponade — hypotension, jugular venous distension, and muffled heart sounds.

pulsus paradoxus

A fall in systolic blood pressure of more than 10 mmHg on inspiration; a sign of cardiac tamponade.

blunt aortic injury

A deceleration injury (often a high-speed MVC) that can tear the aorta at the isthmus; suspected with a widened mediastinum and controlled with strict heart-rate and blood-pressure reduction.

FAST

Focused Assessment with Sonography for Trauma — bedside ultrasound for free fluid in the perihepatic, perisplenic, pelvic, and pericardial spaces; eFAST also checks the chest.

pelvic binder

A device that circumferentially compresses an unstable pelvic fracture to reduce pelvic volume and control venous bleeding; applied at the level of the greater trochanters.

hemorrhagic shock

Hypovolemic shock from blood loss, graded I–IV by volume lost; tachycardia and a narrowing pulse pressure are early, while hypotension is a late sign.

compartment syndrome

Rising pressure in a closed fascial compartment causing ischemia; the 6 P's (pain, paresthesia, pallor, pulselessness, paralysis, poikilothermia) — a fasciotomy emergency.

fat embolism syndrome

Fat globules entering circulation after long-bone or pelvic fractures, classically causing hypoxia, neurologic changes, and a petechial rash 24–72 hours after injury.

rhabdomyolysis

Muscle breakdown releasing myoglobin (e.g., after a crush injury) that can cause acute kidney injury; marked by elevated CK and dark, tea-colored urine; treated with aggressive IV fluids.

Rule of Nines

A method to estimate burn total body surface area in adults: head 9%, each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, perineum 1%.

Parkland formula

A burn fluid estimate: 4 mL lactated Ringer's × weight (kg) × %TBSA, half in the first 8 hours from the burn, the rest over 16 hours; titrate to urine output.

massive transfusion protocol

Rapid delivery of large volumes of blood products to a hemorrhaging patient, using a balanced 1:1:1 ratio of packed red cells, plasma, and platelets.

TXA

Tranexamic acid — an antifibrinolytic that reduces death from traumatic hemorrhage when given early (ideally within 3 hours of injury).

trauma triad of death

The lethal, self-reinforcing combination of hypothermia, acidosis, and coagulopathy that worsens bleeding in severe trauma; the BCEN outline names the updated 'trauma diamond of death,' which adds hypocalcemia as a fourth vertex.

permissive hypotension

Targeting a lower-than-normal blood pressure before surgical hemorrhage control (in selected patients without TBI) to avoid dislodging clots and diluting clotting factors.

perimortem cesarean

An emergency delivery considered within about 4 minutes of maternal cardiac arrest after roughly 20–24 weeks to aid maternal and fetal survival.

START triage

Simple Triage And Rapid Treatment — a mass-casualty system using respirations, perfusion, and mental status to sort patients into immediate (red), delayed (yellow), minor (green), and expectant/deceased (black).

trauma triage

The field and hospital process of matching an injured patient to the right level of trauma care, balancing undertriage (missing serious injury) against overtriage.

injury prevention

Trauma-nurse activity to reduce injury through primary (preventing the event), secondary (reducing severity), and tertiary (optimizing recovery) prevention.

TCRN Study Guide FAQ

References

1. 1.Board of Certification for Emergency Nursing. “Trauma Certified Registered Nurse (TCRN).” BCEN. ↑
2. 2.Board of Certification for Emergency Nursing. “TCRN Examination Content Outline (effective 11/2025).” BCEN. ↑
3. 3.Board of Certification for Emergency Nursing. “TCRN Eligibility & Frequently Asked Questions.” BCEN. ↑
4. 4.American College of Surgeons. “Advanced Trauma Life Support (ATLS) & Trauma Quality Programs (TQIP).” ACS. ↑
5. 5.American College of Surgeons. “ACS TQIP Best Practices Guidelines (Massive Transfusion, TBI, Geriatric Trauma).” ACS. ↑
6. 6.Centers for Disease Control and Prevention (CDC). “Traumatic Brain Injury & Concussion.” CDC. ↑
7. 7.Centers for Disease Control and Prevention (CDC). “Older Adult Falls & Injury Prevention.” CDC. ↑
8. 8.National Institutes of Health / National Library of Medicine. “StatPearls & MedlinePlus Clinical Reference (trauma topics).” NIH/NLM. ↑
9. 9.American Association for the Surgery of Trauma (AAST). “Organ Injury Scaling.” AAST. ↑

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