# MOI NOI TRAUMA and MEDICAL



## AshlynnUnbewust (Mar 16, 2014)

I'm writing a paper and the topic is describe how to determine the MOI or NOI at an emergency and the importance of differentiating trauma patients from medical patients. Honestly I don't know how to start this paper. and i don't understand what hes asking for us to do. so plenty of help is needed and i thank you for your help


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## SandpitMedic (Mar 16, 2014)

I don't know what you're talking about either. 

Are you in an EMS class? Are you an EMT/NRP?

Generally you see an MOI right off the bat... Oh look at that rope they tried to hang themselves with, etc.

NOI is pretty simple too... Is it cardiac, respiratory, behavioral, environmental, abdominal, toxicological, etc. You look around and assess your patient to figure it out.


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## STXmedic (Mar 16, 2014)

Well, you aren't alone, OP. If that's all you have to go on, I don't know what kind of paper he expects you to write. I don't even see why he wants you to distinguish between trauma and medical. It's usually fairly obvious. Like sandpit said, do they have a bullet hole in them? Trauma. Are they having an asthma attack? Medical. I could care less what category they fall into, it doesn't typically affect my treatment plan.

If you want to stretch, you could say something about, I don't know, hypotension. If its trauma, you may expect a bleed. If its medical, you may expect damn near anything. 

Yeah, you have fun with that. I don't know what this guy is getting at.


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## mycrofft (Mar 17, 2014)

Too vague.
Go with the Greg House, MD path: "Paraneoplastic Syndrome".


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## ambo000 (Mar 22, 2014)

Definitely agree with the preceding posts... this paper sounds like it was designed by Captain Obvious... but...

Just to get something on your paper, perhaps try to explore the MOI/ NOI element of the question from all dimensions e.g.

Begin with the obvious and state the patients signs/symptoms and how they indicate medical/ trauma issues (pretty self explanatory I would assume.. but give him what he wants).

Take it to the next step and then state how the scene/environment also indicate whether the job may be trauma/ medical in nature e.g. NOI determination might be assisted by items such as medic-alert bracelets,  medication boxes lying around someones house, strange smells etc while MOI might be determined by weapons, fallen ladders pinning pt to the ground, smashed vehicles etc (again all very obvious).

I'd pretty much state anything that may indicate or consolidate initial suspicions of a particular medical or trauma problem when evaluated in conjunction with the pt's presenting condition and chief complaint.

As for the differentiation between the medical and trauma part of the question... I'd simply define a medical call vs a trauma call and perhaps provide some supporting examples of the two different types of jobs e.g. trauma = abdominal evisceration... whilst medical = chest pain... The importance in differentiating between the two (as far as I'm concerned) is irrelevant... I treat my medical pts just as seriously as my trauma pt's and vice versa... my treatment will not be influenced by the type of call but instead by the pt's presentation... 

Perhaps mentioning the importance of exploring possible double presentations could get you a few brownie points e.g. you are called to a patient who has sustained head trauma after falling down the stairs and hitting their head (this would obviously be classed as trauma) however it is important to explore possible pre- existing medical problems that may have caused the fall in the first place e.g. don't simply assume the pt tripped down the stairs perhaps they has a stroke, LOC etc.. in this sense you are dealing with both a medical and trauma job at the same time.

Hope this shed a little bit of light on the situation. I'm sorry you have to write such a vague and ambiguous paper. All the best!!


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## mycrofft (Mar 22, 2014)

We broached this recently in anther thread.
Trauma is surgical (get to hospital for cutting), most others are medical (use drugs to get to hospital then medicine not cutting.


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## Underoath87 (Mar 22, 2014)

mycrofft said:


> We broached this recently in anther thread.
> Trauma is surgical (get to hospital for cutting), most others are medical (use drugs to get to hospital then medicine not cutting.



What about medical emergencies that require surgical intervention?  (i.e. ruptured appendix)


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## UnkiEMT (Mar 22, 2014)

mycrofft said:


> We broached this recently in anther thread.
> Trauma is surgical (get to hospital for cutting), most others are medical (use drugs to get to hospital then medicine not cutting.


See, if I was looking for a general definition to differentiate the two, I'd say that trauma arises from the application of external energy, be it kinetic, thermal, electrical or chemical (possible some other form I'm not thinking of right now.) Whereas medical arises from an internal disease process.

When you have a pt with elements of both, then it becomes a matter of picking whichever one is more significant.


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## mycrofft (Mar 22, 2014)

In reality, we make such definitions to try to convey information or make personal decisions. They do not reflect the graduations and interconnectedness of things in real cases.


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