Mechanism of injury

Mechanism of injury can be defined as the physical circumstances causing an injury event. Assessment of injury mechanism is frequently used to support clinical and resource decision-making in the pre-hospital and emergency department environments. Pre-hospital examples include whether a patient undergoes spinal immobilization or is transported directly to a multidisciplinary trauma centre.1 In the emergency department, knowledge of the mechanism of injury may be used as a trigger for activation of a trauma team and may alter the thresholds for imaging, intervention or admission. However, there remains some debate regarding whether the mechanism of injury accurately predicts either the severity of injury or the need for specialist resources. The central paradox is that several studies have shown that knowledge of the mechanism of injury does not correlate well with severity of anatomical injury or physiological derangement,1,2 whereas other studies have demonstrated, conversely, that in certain groups of patients the mechanism of injury does accurately predict mortality and need for specialist care.