Mechanism of Injury (MOI)

Assessment Techniques

Assessment techniques for mechanism of injury (moi):

Cincinnati Stroke Scale

Components: Facial droop, Arm drift, Speech abnormality. Scoring: Any 1 positive = 72% probability of stroke

Trauma Score

Components: GCS, Systolic BP, Respiratory rate. Scoring: Revised Trauma Score: coded values 0-4, sum correlates with survival probability

SAMPLE

Components: Signs/symptoms, Allergies, Medications, Past history, Last intake, Events. Scoring: Mnemonic for patient history gathering

Documentation

Documentation of mechanism of injury (moi) in the patient care report (PCR) must include: time of assessment, findings, interventions performed, patient response, and reassessment findings. Use objective, measurable terms like "patient reports 8/10 chest pain" rather than "patient in pain." Document pertinent negatives. All medications administered must include drug name, dose, route, time, and patient response.

Regulatory Context

Regulatory context for mechanism of injury (moi) includes federal and state requirements. Healthcare facilities must comply with CMS Conditions of Participation, state licensure requirements, and accreditation standards (Joint Commission or AAAHC). Non-compliance can result in citations, fines, or loss of Medicare/Medicaid reimbursement.

Workplace Applications

In daily practice, mechanism of injury (moi) is applied consistently according to facility protocols and current evidence-based guidelines. Competency is maintained through annual skills validation, continuing education, and quality improvement participation.

Clinical Significance

In prehospital care, understanding mechanism of injury (moi) can mean the difference between a positive patient outcome and a critical miss. An 8-month-old infant is found unresponsive. Parents report fever of 104 F for 2 days. Fontanelle is bulging. Suspect meningitis: manage airway, IV access, rapid transport.

Related pharmacology: dextrose at D50W 25g IV (adult), D25W 2-4 mL/kg (peds), indicated for Hypoglycemia.