Wednesday, October 18, 2023

EMS Trauma Assessment - Index of Suspicion & Mechanism of Injury


EMS Providers play a crucial role in assessing and managing trauma emergencies. Two important concepts they need to understand are the Index of Suspicion and Mechanism of Injury. These concepts help EMTs make quick and informed decisions about the care of trauma patients.

Index of Suspicion (IOS):

The IOS is an essential element in the assessment of trauma patients. It refers to the level of concern or suspicion an EMS Providers should have regarding potential injuries or conditions.

EMS Providers must maintain a high index of suspicion, especially in trauma situations, because injuries are not always immediately evident. This means considering the possibility of severe injuries even when there are no obvious signs or symptoms.

A high index of suspicion should be maintained for patients involved in high-impact mechanisms of injury, such as car accidents, falls from heights, or severe blows.

EMS Providers should consider the mechanism of injury, the patient's presentation, and the nature of the incident to determine the likelihood of hidden injuries. A high index of suspicion prompts a thorough assessment and treatment.

Mechanism of Injury (MOI):

The MOI is an important aspect of the assessment process for trauma patients. It involves understanding how the injury occurred, the forces involved, and the potential for damage to specific body parts or systems.

EMTs should gather information about the MOI from the scene, bystanders, and the patient whenever possible. Common mechanisms of injury include:

Motor Vehicle Accidents: Speed, type of collision, airbag deployment, seat belt use, intrusion into the vehicle, etc.

Falls: Height of fall, landing surface, position of the body during the fall, and age of the patient.

Assaults: The type of weapon or force used, number of assailants, and locations of injuries.

Penetrating injuries: The object causing the injury, its size, and depth of penetration.

Understanding the MOI helps EMS Providers predict potential injuries. For example, if a patient was involved in a high-speed car crash with significant vehicle damage, the EMT should be highly suspicious of head, neck, and chest injuries even if the patient is alert and without immediate complaints.

Combining the MOI with the patient's presentation and a high index of suspicion guides EMTs in making critical decisions regarding patient care, such as spinal immobilization, oxygen therapy, and the need for rapid transport to a trauma center.

EMS Providers need to maintain a high index of suspicion, especially in trauma cases, and carefully assess the mechanism of injury. These concepts, when used together, allow EMTs to provide timely and appropriate care to trauma patients, even when injuries may not be readily apparent.


Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach. 2nd Ed. Hoboken, New Jersey: Pearson Education

Limmer Education (2021) What Does Mechanism Of Injury Tell Us? Accessed on October 15, 2023

Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care. 11th Ed. Hoboken, New Jersey: Pearson Education  

#EMS #IndexofSuspicion #MechanismofInjury #PatientAssessment #TraumaAssessment #MotorVehicleAccidents

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