As a part of the assessment of trauma patients, how important is Mechanism Of Injury?
If there is one thing that Mechanism Of Injury definitely is not – that thing is patient assessment.
Mechanism Of Injury is assessment of the kinematics of the delivery of forces to the patients body. Fortunately, EMS requires a degree in Physics with a Kinematics major. If that were not the case, we would not have this over-triage rate that encourages blind squirrels to laugh at us.
Using Mechanism Of Injury alone, our over-triage rate is about 99%.
In other industries, this would be considered a humiliating failure. In EMS, we suggest that Mechanism Of Injury just needs the slightest tweak and it will be just right. Our Tweaking makes the other Tweaking look almost smart. Almost.
Our medical command permission system may not be much better than paying a psychic for a phone consult. However, the psychic might be more likely to order pain medicine for patients in severe pain. Might – anyone who engages in this kind of fraud cannot be considered empathetic.
Given this pathetic lack useful information, why do we pay so much attention to Mechanism Of Injury?
Maybe you doubt my comment that Using Mechanism Of Injury alone, our over-triage rate is about 99%.
The following results combined show a less than 1% ability to predict major trauma.
Image source. Click on image to make it larger.
Motor vehicle collision at a speed greater than 60 KMH (just over 37 MPH)?
Have any of us ever been required to demonstrate that we can estimate motor vehicle collision speeds?
All we do is invoke the Barney Rule – We use our imaginations.
We need to stop paying so much attention to Mechanism Of Injury.
We need to pay more attention to actual patient assessment.