NREMT EMT 1 Scene Size Up and Safety Mechanism of injury MOI vs nature of illness NOI

What This Is: Mechanism of Injury (MOI) vs. Nature of Illness (NOI)

When someone gets hurt or falls ill, it's essential to figure out what happened and what's going on. Think of it like a puzzle: MOI is like the pieces that fell off the table (how the injury happened), while NOI is like the picture on the wall (what's actually wrong with the person). For example, if someone breaks their leg in a car accident, the MOI is the car crash, and the NOI is the broken leg.

Key Steps / Core Facts:

• Mechanism of Injury (MOI): The events that led to the injury or illness. It matters because it helps us understand what happened and how to treat it. Example: A car crash (MOI) caused a head injury (NOI).
• Nature of Illness (NOI): The underlying condition or disease. It matters because it helps us determine the best course of treatment. Example: A head injury (NOI) from a car crash (MOI).
• Primary vs. Secondary Assessment: Primary is the initial assessment (MOI), while secondary is the more detailed assessment (NOI). It matters because it helps us prioritize treatment. Example: Check for danger (primary) before checking vital signs (secondary).
• AMPLE History: Allergies, Medications, Past medical history, Last meal, Events leading up to the injury or illness. It matters because it helps us understand the patient's overall health. Example: "I'm allergic to penicillin" (AMPLE).
• OPQRSTI: A mnemonic to help us remember the key questions to ask during the secondary assessment. It stands for:
  • O: Onset (when did it start?)
  • P: Provocation (what makes it worse?)
  • Q: Quality (what does it feel like?)
  • R: Region (where is it?)
  • S: Severity (how bad is it?)
  • T: Time (how long has it been like this?)
  • I: Intensity (how intense is it?)
• Red Flags: Danger signs that indicate a more serious condition. Example: Severe headache, difficulty breathing, or severe chest pain.
• Cervical Spine Clearance: Checking for neck injuries. It matters because it helps prevent further injury. Example: Use the "log roll" technique to clear the cervical spine.
• Vital Signs: Checking temperature, pulse, breathing rate, blood pressure, and oxygen saturation. It matters because it helps us understand the patient's overall health. Example: Normal temperature is between 97.7°F and 99.5°F.
• CPR Compression Depth: At least 2 inches (5 cm) – like pushing down a soda can. It matters because it helps us provide effective CPR. Example: 30:2 ratio (30 compressions to 2 breaths).
• CPR Ratio: 30:2 (30 compressions to 2 breaths) for adults and children, and 30:3 for infants. It matters because it helps us provide effective CPR.

What Laypeople Can Do:

• If someone collapses, first check for danger (oncoming traffic, fire). Then shout and tap their shoulder.
• If someone is choking, encourage them to cough or try the Heimlich maneuver (back blows).
• If someone is bleeding, apply pressure with a clean cloth or bandage.
• If someone is having a seizure, move them to a safe area and turn them onto their side.
• If someone is having a heart attack, call 911 and provide any information you can.

Common Mistakes:

• Mistake: Not checking for danger before providing care.
• Fix: Always check for danger first, then provide care.
• Mistake: Not using the correct CPR ratio.
• Fix: Use the 30:2 ratio for adults and children, and 30:3 for infants.
• Mistake: Not clearing the cervical spine before moving a patient.
• Fix: Use the "log roll" technique to clear the cervical spine.

Quick Practice Scenarios:

1. A person is brought to the hospital after a car crash. What should you do first?

Answer: Check for danger (oncoming traffic, fire) before providing care.
Reason: To prevent further injury.

1. A person is having a seizure. What should you do first?

Answer: Move them to a safe area and turn them onto their side.
Reason: To prevent injury from the seizure.

1. A person is having a heart attack. What should you do first?

Answer: Call 911 and provide any information you can.
Reason: To get medical help as quickly as possible.

Last-Minute Exam Cram:

• ⚠️ Agonal breathing is NOT normal breathing – start CPR.
• Normal temperature is between 97.7°F and 99.5°F.
• The 30:2 CPR ratio is for adults and children.
• The 30:3 CPR ratio is for infants.
• The "log roll" technique is used to clear the cervical spine.
• The OPQRSTI mnemonic helps us remember the key questions to ask during the secondary assessment.
• The AMPLE history helps us understand the patient's overall health.
• Cervical spine clearance is essential to prevent further injury.
• CPR compression depth should be at least 2 inches (5 cm).
• Normal blood pressure is between 90/60 and 120/80 mmHg.
• Normal pulse is between 60 and 100 beats per minute.
• Normal breathing rate is between 12 and 20 breaths per minute.
• Normal oxygen saturation is between 95% and 100%.
• ⚠️ Do NOT move a patient with a suspected spinal injury.