TNCC certification — the Trauma Nursing Core Course — is the professional credential for emergency and trauma nurses, certifying competency in the systematic assessment and care of trauma patients. Developed and administered by the Emergency Nurses Association (ENA), TNCC teaches nurses the trauma nursing process: primary and secondary survey, airway management, hemorrhage control, and care of patients with musculoskeletal, thoracic, abdominal, and neurological trauma. TNCC certification is required or strongly preferred by trauma centers, emergency departments, and flight nursing programs across the United States. This guide covers who needs TNCC, what the course involves, how to take the exam, the cost, and how to renew TNCC certification when it expires.
The TNCC (Trauma Nursing Core Course) is a two-day continuing education course and certification program developed by the Emergency Nurses Association (ENA). It is designed for registered nurses who care for trauma patients in emergency departments, trauma centers, intensive care units, and pre-hospital/flight settings. TNCC provides nurses with a standardized, systematic approach to trauma patient assessment and initial stabilization based on the current evidence-based Trauma Nursing Process.
The Trauma Nursing Process taught in TNCC:
TNCC is the nursing equivalent of ATLS (Advanced Trauma Life Support, which is the physician-focused trauma certification). Together, TNCC-certified nurses and ATLS-certified physicians form the core of trauma resuscitation teams at designated trauma centers.
The TNCC trauma nursing course is offered at hundreds of hospitals and ENA-approved facilities nationwide, with course dates available throughout the year.
The standard TNCC course is a two-day, in-person educational program:
Day 1 — Lectures and skill stations (provider manual content):
Day 2 — Psychomotor skill stations and written exam:
9th Edition: The current TNCC curriculum is the 9th Edition — introduced in 2020. Key updates from previous editions include enhanced focus on hemorrhage control (tourniquet and wound packing), updated spinal motion restriction guidance, and integration of high-quality CPR principles for traumatic cardiac arrest. All current TNCC courses use the 9th Edition provider manual.
To earn TNCC certification, candidates must pass both components:
Written examination:
Psychomotor skill evaluation:
Most candidates who complete the pre-course online modules and practice the TNCC assessment process are well-prepared for both components. See our TNCC certification practice questions for written exam preparation.
TNCC certification is required or strongly preferred for nurses in these settings:
TNCC is appropriate for nurses who are new to trauma care and for experienced trauma nurses seeking certification renewal or systematic skills update. There is no experience requirement to attend a TNCC course — many nurses complete TNCC early in their emergency nursing career.
Cost: TNCC course fees vary by region and hosting facility. Most courses cost between $350 and $600 for the two-day program, which typically includes the provider manual. ENA members may receive a discount. Many hospitals and health systems cover the TNCC course fee for emergency nurses and trauma nurses as a continuing education benefit.
Validity: TNCC certification is valid for 4 years from the date of successful completion. Unlike some certifications that offer a CEU-based renewal option, TNCC renewal requires retaking the full course — there is no exam-only renewal pathway. This ensures all TNCC providers remain current with the evolving 9th Edition curriculum and skill standards.
How to renew TNCC: