Delayed diagnosis in a rural trauma center

Lodox/Statscan facilitates the early detection of commonly overlooked extracranial injuries in patients with traumatic brain injury

“…Consequently, it was reported that 10-39.6% of extremity injuries were missed in the ED and diagnosed later in the ward, intensive care unit (ICU), or even in outpatient departments [7][8][9]. Apart from the possible increased risk of fat embolism syndrome and compartment syndrome, there are also possible legal concerns if a significant long bone fracture is missed [10][11][12][13]. Therefore, clinicians face a dilemma regarding the evaluation of patients with diminished level of consciousness in the ED.…”

Trauma Care at Rural Level III Trauma Centers in a State Trauma System

“…It should be remembered that initial assessment and prioritization of care is the cornerstone of trauma management, resting largely on the shoulders of the trauma surgeon, and the occurrence of missed injuries, even in trauma centers, is a danger. Aaland and Smith, 16 reporting from a rural trauma center, pointed out that 3% of 1,876 patients were found to have missed injuries, including arterial and bowel injuries, from which 34% required operative intervention and one patient died. Moreover, daily rounds by traumaoriented health care providers, specifically trauma surgeons, has been shown to decrease length of stay 17 and may have a particularly beneficial effect on this patient population.…”

Commonly missed injuries in the accident and emergency department

“…Trauma 2004; 6: 41±51 in several series (Born et al, 1989;Buduhan and McRitchie, 2000;Aaland and Smith, 1996). The mean delay was 14.6 days.…”

“…The mean delay was 14.6 days. In one series, 13% of patients were diagnosed in the trauma clinic after discharge from hospital (Aaland and Smith, 1996).…”