Mechanism of Injury and Nature of Illness - NREMT: EMT Level

MOI: force/energy causing trauma; NOI: medical complaint or disease process. MOI identifies the physical forces causing trauma, while NOI describes the underlying medical condition or pathology affecting the patient.

Predict likely injuries/illness patterns and prioritize life threats. Early MOI/NOI identification enables anticipation of hidden injuries or conditions, guiding prioritization of critical interventions.

Blunt: energy spreads; penetrating: energy focused along an object path. Blunt trauma dissipates kinetic energy over a broad area, whereas penetrating trauma concentrates it along the penetrating object's trajectory.

Significant MOI with potential for occult life threats. A significant MOI implies high-energy transfer that can cause internal injuries not immediately visible, requiring heightened vigilance.

Minimize spinal movement and use spinal motion restriction as indicated. Suspected spinal injury from MOI requires restricting movement to prevent further damage to the spinal cord or vertebrae.

Shear/tear injuries such as aortic injury and solid-organ damage. Rapid deceleration creates shearing forces that tear mobile structures from fixed ones, leading to vascular and organ injuries.

Cervical spine fracture and spinal cord injury. Axial loading compresses the cervical spine vertically, often resulting in fractures and potential cord damage in diving incidents.

Calcaneus/ankle fractures and possible spinal compression fractures. Landing on feet transmits force upward, fracturing lower extremities and compressing the spine in high falls.

Wrist/forearm fractures and possible shoulder/clavicle injury. Outstretched hand absorbs impact force, transmitting it to the wrist, forearm, and potentially proximal structures like the shoulder.

Head, chest, abdominal, and pelvic injuries on the impact side. Lateral impacts direct force to one side, increasing risk of trauma to head, thorax, abdomen, and pelvis on the struck side.

Head/face trauma, chest injury, and lower-extremity injuries. Frontal collisions cause forward momentum, leading to impacts on the head, chest from steering wheel, and legs from dashboard.

Cervical spine strain (whiplash) and possible spinal injury. Rear-end impacts cause hyperextension-hyperflexion of the neck, straining cervical muscles and potentially injuring the spine.

Blunt torso trauma (chest/abdomen/pelvis) with significant force. Blunt force to the torso can rupture vessels and organs internally without visible external trauma, leading to occult hemorrhage.

Temporary tissue displacement causing damage beyond the wound path. Cavitation occurs when high-velocity projectiles create a temporary cavity, expanding tissue damage beyond the direct wound track.

Facial/upper-extremity abrasions, eye injury, and chest wall trauma. Airbag deployment releases force and chemicals, causing abrasions, ocular trauma, and contusions to face, arms, and chest.

High-energy transfer with increased risk of serious injury. Vehicle intrusion indicates substantial kinetic energy absorption by the occupant, correlating with severe injury potential.

Explosion exposure with possible barotrauma and penetrating fragments. Blasts produce pressure waves causing barotrauma to air-filled organs and propel fragments leading to penetrating injuries.

Airway injury and inhalation/CO poisoning in addition to skin burns. Closed-space fires trap smoke and toxins, increasing risks of airway burns, inhalation injury, and carbon monoxide poisoning.

Chest pressure with dyspnea, diaphoresis, nausea, or radiating pain. These symptoms indicate myocardial ischemia, requiring prompt recognition for potential acute coronary syndrome management.

Sudden facial droop, arm drift/weakness, and speech difficulty. These signs align with the FAST criteria for stroke, emphasizing time-sensitive intervention to minimize brain damage.

Respiratory distress plus hypotension and hives/angioedema. Anaphylaxis involves systemic allergic response, distinguishing it from asthma by adding circulatory and dermatologic signs.

Suspected infection with fever or hypothermia and altered mental status. Sepsis presents with systemic infection signs and organ dysfunction, often manifesting as temperature dysregulation and confusion.

Hypoglycemia until proven otherwise. Altered mental status and diaphoresis in diabetics commonly result from low blood sugar, necessitating immediate glucose assessment.

Acute stroke or intracranial hemorrhage. Sudden severe headache with deficits suggests vascular events like hemorrhage or ischemia, requiring urgent neurological evaluation.