Missed injuries are fortunately rare, yet the injured trauma patient may present a unique diagnostic challenge...
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
When treating a patient in cardiac arrest from a blunt trauma, providers need to balance the potential risk of harm to provider and staff before performing an invasive procedure with a very low chance of success.
Potential adverse health effects associated with radiation exposure are an important factor to consider when
selecting the appropriate imaging procedure. Because there is a wide range of radiation exposures associated with
different diagnostic procedures, a relative radiation level (RRL) indication has been included for each imaging
Trauma is the leading cause of morbidity and mortality in patients under 35-years of age and the sixth leading cause of death worldwide. The majority of serious traumatic injuries are due to blunt trauma from motor vehicle crashes and pedestrian injuries.
The most common cause of blunt laryngotracheal trauma is motor vehicle accidents. Patients typically present with dyspnea, dysphonia, neck pain, dysphagia, odynophagia, and hemoptysis. Physical findings may include subcutaneous emphysema, tenderness, edema, hematoma, ecchymosis, and distortion or loss of laryngeal landmarks. Laryngotracheal injuries are often unrecognized because the severity of the symptoms does not always correspond with the extent of injury.
Use of computed tomography (CT) scans of the chest for hospital emergency-room patients with blunt trauma could be reduced by more than one-third without compromising detection of major injury, concludes a new study led by a UC San Francisco physician.
This is the first study to assess patient outcomes with respect to FAST in the era of early whole body CT in trauma. Although FAST does not directly impact care for the majority of blunt trauma patients, it demonstrates usefulness in some patients by directing CT utilization and expediting disposition from the ED.
There may be a role for ED thoracotomy after blunt trauma, but only in a limited group of patients. Good outcomes have been achieved for patients who had vital signs on admission and for patients who received an ED thoracotomy within 15 minutes of cardiac arrest. The proposed guideline should be used to determine which patients should be considered for an ED thoracotomy, according to level 4 evidence.
Blunt trauma: most common overall cause of trauma in the United States. ~75% are from MVCs.
Blunt forces push against the anterior thorax and abdomen, compressing viscera against the posterior thoracic cage or vertebra, causing crushing of tissue and shearing open organs at their point of attachment to the peritoneum.
What body parts are at higher risk for missed injuries?
The most commonly involved body region of missed injuries was the head/neck, followed by the chest and extremities.