Trauma CornerMissed traumatic injuries: A synopsis
Common themes associated with missed injuries are discussed, and steps that practitioners can take are highlighted to minimize delays in diagnosis and to reduce the number of missed injuries.
Abstract
The ultimate goal in trauma resuscitation is to promptly identify and treat all injuries. Despite clinical and technological advances in diagnosis and treatment of trauma patients, missed injuries continue to significantly affect modern trauma services. Delayed diagnosis and missed injuries have the potential to exacerbate the severity of the initial insult, and may result in permanent disability or even mortality. Moreover, missed injuries add significantly to length of hospitalization and overall costs of trauma patient care. This article will discuss common themes associated with missed injuries, and will highlight steps that practitioners can take to minimize delays in diagnosis and to reduce the number of missed injuries. This article begins with basic definitions, followed by a discussion of literature pertaining to, and factors associated with, missed injuries. We will then focus on specific mechanisms and injury patterns, as well as the corresponding injury-specific diagnostic and treatment pitfalls that have to be considered in order to avoid