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![Injury: Mechanism of Injury
• Child and Adult Abuse Mechanism Codes:
• Primary Mechanism: Enter mechanism code of “child abuse” or “adult abuse.
[T74, Adult and child abuse, neglect and other maltreatment, confirmed) or T76,
Adult and child abuse, neglect and other maltreatment, suspected) for abuse, neglect
and other maltreatment]
• Secondary Mechanism: Enter perpetrator – if a confirmed child abuse case.
• For confirmed cases, the external cause code section (X92 – Y09) should be
reported along with documented injuries. A perpetrator code (Y07) is reported
when the person who performed the abuse/neglect is known.
• For suspected but not confirmed cases, the perpetrator is not reported.
• Tertiary Mechanism: Enter type of mechanism – how assaulted – burned,
dropped, struck, etc.](https://image.slidesharecdn.com/injuryatrtrainingfinal2020-200618165800/85/Injury-atr-training-final-2020-19-320.jpg)
Injury atr training final 2020
- 1. Alaska Trauma Registry Training TRAUMAPROGRAM RURAL AND COMMUNITY HEALTH SYSTEMS STATE OF ALASKA, DIVISION OF PUBLIC HEALTH
- 2.
- 3. Two tabs under Injury: InjuryInformation Mechanism of Injury
- 4. Let’s look atthe registry
- 5. Injury: Injury Information •Injury Date and Time • Please try to find both date and time • Very important data for trauma system evaluation • Estimates of date and time of injury should be based upon report by patient, witness, family, or health care provider • Very important data for QI review for survival • Greater time between injury and treatment may adversely affect outcome
- 6. • ICD 10Location Code • Formerly called Place of Occurrence • Place/site/location where the injury event occurred • Take time to look through all the expanded list of ICD 10 location codes • Primary mechanism code includes location (usually transport vehicle) then list location of that transport vehicle • Car crash what type of street was patient’s car traveling on • Do not enter “unknown”, use Y92.0 unspecified place Injury: Injury Information
- 7. • ICD 10Location Code • Y92.0 – Y92.09 Non-Institutional (private) residence • Y92.1 – Y92.19 Institutional (non-private) residence • Y92.2 – Y92.29 School, Other institution and public administrative area • Y92.3 – Y92.39 Sports and athletics area • Y92.4 – Y92.48 Street, Highway and other paved roadways • Y92.5 – Y92.59 Trade and Service area • Y92.6 – Y92.69 Industrial and construction area • Y92.7 – Y92.79 Farm • Y92.8 – Y92.89 Other Places • Y92.9 Unspecified Place Injury: Injury Information
- 8. • Registry canhelp you • Type in one-word description of location • Select search • All relevant location codes will be brought up • List for kitchen Injury: Injury Information
- 9. I • ICD 10Location Specify • Opens only for “other” locations. • Use only 1- or 2-words description of location • Don’t repeat the primary mechanism specify information Injury: Injury Information
- 10. • Subsistence • Personlives in Alaska EXCEPT from: • Anchorage, Mat-Su, Fairbanks, or Juneau • Hunting, fishing, trapping, whaling or gathering in Alaska at time of injury • Not related to “subsistence license” Injury: Injury Information
- 12. • Subsistence • Work-Related •Separate presentation to complete after injury section Injury: Injury Information
- 13. • Injury Address:Street 1 • Incident physical street address • Do not enter P.O. Box • Street Intersection • Mile Post # of Highway • Can leave blank • Only if no information of address is available • Free-text address information • 30 miles of Dutch Harbor in Bering Sea Injury: Injury Information
- 14. Injury: Injury Information •Injury Occurring in Ocean • Injury City, County, Census Area, State will be the port of call where the injured person is taken off the boat to get care. • Person on cruise ship on inland passage falls & breaks hip, care provide in ship clinic until arrive in port in Sitka. • Enter zip code for Sitka • Manually enter all injury address fields for Sitka
- 15. Two tabs under Injury: InjuryInformation Mechanism of Injury
- 16. Let’s look atthe registry
- 17. Injury: Mechanism ofInjury • Primary ICD 10 Mechanism Code • External cause code is used to describe the mechanism (or external factor) that caused the injury event • Mechanism MUST entered with all capital letters • The Primary mechanism should describe the main reason a patient is admitted to the hospital. • The first mechanism code, should correspond to the injury cause of the most serious diagnosis, due to an assault, accident, or self-harm UNLESS the injury is from child or adult abuse, terrorism event, cataclysmic event or transport accidents
- 18. Injury: Mechanism ofInjury • Hierarchy of Mechanism Codes • The first listed External cause code should correspond to the cause of the most serious diagnosis due to an assault, accident, or self- harm, following the order of hierarchy listed below: • Mechanism of Injury codes for children and adult abuse take priority over all other codes. • Mechanism of Injury codes for terrorism events take priority over all other codes except child and adult abuse. • Mechanism of Injury codes for cataclysmic events take priority over all other codes except child and adult abuse and terrorism. • Mechanism of Injury codes for transport accidents take priority over all other codes except child and adult abuse, terrorism, and cataclysmic events.
- 19. Injury: Mechanism ofInjury • Child and Adult Abuse Mechanism Codes: • Primary Mechanism: Enter mechanism code of “child abuse” or “adult abuse. [T74, Adult and child abuse, neglect and other maltreatment, confirmed) or T76, Adult and child abuse, neglect and other maltreatment, suspected) for abuse, neglect and other maltreatment] • Secondary Mechanism: Enter perpetrator – if a confirmed child abuse case. • For confirmed cases, the external cause code section (X92 – Y09) should be reported along with documented injuries. A perpetrator code (Y07) is reported when the person who performed the abuse/neglect is known. • For suspected but not confirmed cases, the perpetrator is not reported. • Tertiary Mechanism: Enter type of mechanism – how assaulted – burned, dropped, struck, etc.
- 20. Injury: Mechanism ofInjury • Primary Mechanism Specify • Circumstances and activity of patient prior to and at time of injury • Tell the story of what the patient was doing just prior to injury, what happened to cause the injury; any contributing factors (weather, alcohol, etc.). • Do NOT use abbreviations • Use proper English with punctuation • Do NOT enter in all Capitals • Enter information about perpetrator – relationship to victim; alcohol involvement. • Work-related: Give as much detail about patient’s occupation and employer (if known)
- 21. Injury: Mechanism ofInjury • Secondary ICD 10 Mechanism Code • Additional External Cause Code used in conjunction with the Primary External Cause Code if multiple external cause codes are required to describe the injury event. • Perpetrator T07 codes entered in this field.
- 22. Injury: Mechanism ofInjury • Injury Type • Blunt • Penetrating • Burn • Cold Injury • Drowning • NA (Poisonings Hanging, and Asphyxiations/Suffocations)
- 23. Injury: Mechanism ofInjury • Injury Type • Auto-fills from primary mechanism code • Double check • Blank – must complete • Definitions of each injury type in Data Dictionary • Mandatory element
- 24. Injury: Mechanism ofInjury • Injury Intent • Whether an injury was caused by an act carried out on purpose by oneself or by another person(s), with the goal of injuring or killing • Auto-fills from primary mechanism code • The primary mechanism and injury intent must match • If assault primary mechanism code injury intent is intentional, assault • Mandatory element
- 25. Injury: Mechanism ofInjury • Injury Intent • Intentional, Self-Inflicted • Intentional, Assault • Unintentional • Unintentional • If no documentation stating intent was assault or self-inflicted, default to unintentional
- 26. Injury: Mechanism ofInjury • Activity Code • Supplemental codes • Indicate the activity that contributed to or caused the injury • Not used when reporting poisonings
- 27. Injury: Mechanism ofInjury • Injury Cause • Categorizing the injury cause • Optional • Facility use
- 28. Injury: Mechanism ofInjury • External Cause Status • Status of the person at the time the event • Optional • Civilian activity done for income or pay • Military activity • Volunteer activity • Other external cause status • Unspecified external cause status •
- 29. Injury: Mechanism ofInjury • Protective Devices • Evidence of the use of safety equipment may be reported or observed • Enter patient use of safety equipment that is the industry standard • Appropriate safety equipment not used enter “None” • If there is no appropriate safety equipment for the activity enter “NA” • Follow Alaska Data Dictionary (not NTDB’s)
- 30. Injury: Mechanism ofInjury • Protective Devices • Restraints • Seatbelts and shoulder harness • For motor vehicle crash • Reported or observed • 3-point restraints use 6, lap belt and shoulder harness • Child restraints not properly used enter None
- 31. Injury: Mechanism ofInjury • Protective Devices • Airbags • For motor vehicle crash • Reported or observed • Enter NA for vehicle without airbags • Enter up to 4
- 32. Injury: Mechanism ofInjury • Protective Devices • Equipment • Measure using industry standard • Personal floatation • Life jacket, Mustang suit, gumby suit, floaties • Protective Non-Clothing Gear • Shin guards, ice cleats, chest plate, knee pads • Helmet • Bike helmet, hard hat, motorcycle helmet • Protective Clothing • Leathers, welder’s gloves, steel-toed shoes, bunny boots