Friday, January 4, 2008

So much for mechanism of injury

We are taught that falls more than three times the patient's height are considered significant. I'm relatively sure this applies:

‘Miraculous’ Recovery for Man Who Fell 47 Floors

What is very interesting--and often misunderstood--about MOI is that there really is no direct correlation between the guidelines we use and injury. How many times have we gone to a rollover crash and found the uninjured driver standing against the car smoking a cigarette? Or the seemingly minor wreck with serous injuries?

Yet we have nothing else.

While we will use MOI as a guideline for immobilization and sometimes transport decisions, and in fact we may be bound to this by protocol, we should never lose sight of the full patient picture including mental status, vital signs and your clinical intuition and judgement.

MOI is a piece of the puzzle. An important, but limited one. We should apply it to our decision making as such.

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