latestartpremed answered: I would think the more you know, the better the treatment, but I’m not quite advanced enough in my education to have any realy idea.

spearfame said: As radiographers we’re taught to look at the mechanism of injury. By imagining the force we can guess where a fracture might be. It also tells you whether to refer for X-ray or ct, limb imaging or axial imaging. Without that kind of history you’d waste £.

sports-doc answered: I have no clinical experience in trauma but I struggle to see how improving knowledge about the different MOIs could be bad/unimportant.

Thanks guys for some great points of view!

I think you are right, knowing the MOI will help us make better diagnoses and then treatment of the patient and their injuries. Surely that is good medicine?

If there are any trauma docs out there - thoughts?

theboringworldofnielsbohr said: Apparently, A&E numbers are actually falling (Although this does come from the mirror, via a ‘leaked report’, so who knows). Regardless of the numbers, there definitely aren’t enough staff!

It’s a sad state of affairs. But thanks to theboringworldofnielsbohr for pointing out the mirror article ; )

Yeah, we have heard of this magical decrease in patient numbers coming in through the doors of A+E’s throughout the country. It’s also what the government has been saying for ages. But shhhhhh, it’s to do with the same magical world that needs LESS patient beds as less people are being admitted to hospital.

I can honestly say, that in EVERY A+E I have ever worked in around the UK, there has never been a decrease in the number of attendances. EVER! Numbers are increasing every year. Reattendances are increasing too. Hmmm, could this something to do with discharging patients home before they might be ready to go? Yes bed managers I am looking at you. What bed crisis?? HA!

Oooo someone swallowed a bitter pill today! Excuse me folks, gonna eat some chocolate  :)

Thanks lambiemd-ish!

Awwww - its my pleasure! Nothing makes me feel better than a hot cup of tea in the morning. To be honest, it’s the only thing that keeps me going through the shift. Tea lovers unite!! :D And yes coffee too xx

I have been following a very interesting discussion online on a trauma forum as regards whether we need exact details of penetrating trauma in relations to guns.

The trauma forum seems to be mainly based in the USA and there are varied opinions as to how much trauma docs and those in ER require in order to treat the patient with gunshot penetrating trauma. Some very senior doctors are saying you don’t need to know the details, you “just get on and treat the patient in front of you”, others are saying that some details are very important.

There are also arguments in an RTC or for those in the US - MVC, as to not having to know if its a motorbiker vs car or cyclist vs car.

Is it me or is this rather an odd point of view? Maybe its some trauma surgeons vs those working in ER/A+E?

I have always been taught that actually knowing the exact MOI or trauma can give you clues as to what to expect injury wise in a patient. We don’t blindly treat everyone the same. We do try to actually use our clinical accumen and decide that some patients might have a hgher risk of injuries depending on what happened.

So, in relation to motorbiker vs car and cyclist vs car…. what can you expect?

• both serious potentially
• motorbiker at much higher speed (potentially)
• motorbike is heavier and can cause more crush injuries to limbs
• motorbiker wear helmets - how many cyclists do??
• motorbikers (usually) wear protective gear, cyclists don’t.

Therefore, at higher speeds, motorbikers might have far more serious injuries, but they might get away with some due to protective gear. Cyclists, not wearing helmets and not using lights…well. It’s not going to be pretty.

In relation to gunshot wounds - in the military we do try to identify type of rifle/weapon used.  Surely it can give an idea of damage to other tissues? I mean we all studied some ballistics at med school. High velocity vs shotgun blast will give VERY different injuries.

Perhaps for trauma surgeons on the operating theatre it might not matter. They might discount it all. I still think its very useful to use in a trauma situation. Ok so in the UK, we don’t have too many gunshot injuries, but we have lots of stabbings. It’s like discounting if someone was stabbed with a machete/axe/ stilleto blade or a pen knife. All will give rise to organ damage, but our clinical suspicions will be raised with longer blades. Surely this is vital info for any doctor treating the patient??

Thoughts people??