emDocs - July 27, 2016 - Authors: Macdonald C and Waseem M
Edited by: Koyfman A and Alerhand S
"Missed injuries are fortunately rare, yet the injured trauma patient may present a unique diagnostic challenge. Missed injuries and delay in diagnosis remain a concern for ED physicians caring for trauma patients. Delayed diagnosis of intra-abdominal injuries, for instance, results in significantly increased morbidity and mortality. Literature suggests an 8.1% incidence of patients with missed injuries, which may be an underestimation of the true incidence of missed injuries.
Take-home points/Pearls
- Some missed injuries may be due to inadequate clinical assessment; therefore an accurate assessment is very critical to identify injuries.
- A false negative FAST examination is NOT sensitive enough to rule out all abdominal injuries.
- The absence of abdominal pain or tenderness does not rule out significant injury.
- Following ATLS protocol may be helpful for an adequate assessment."
Go here for further reading related to this topic: http://www.emdocs.net/the-cleared-trauma-patient-what-could-we-be-missing/