Unsuspected internal organ traumatic injuries.
Emergency medicine physicians can avoid missed traumatic intra-abdominal injury by adopting a paradigm for patient evaluation that recognizes the patterns of injury associated with pathology, the importance of positive and negative physical findings, and the limitations of diagnostic studies. The burden of avoiding missed traumatic injuries does not rest with emergency medicine physicians alone, however. A missed diagnosis may be the result of a medical error involving multiple systems and individuals.Ultimately, decreasing the incidence of missed traumatic injury is an opportunity for quality improvement for all practitioners involved in the care of patients with trauma.
Department of Emergency Medicine, Boston Medical Center, Dowling 1 South, 818 Harrison Avenue, Boston, MA 02118, USA. sikka@att.net
Rishi
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Sikka
D000007:Abdominal Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D001696:Biomechanical Phenomena; D015984:Causality; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004635:Emergency Medicine / Q000379:methods* / Q000592:standards; D004638:Emergency Treatment / Q000379:methods* / Q000592:standards; D006801:Humans; D007421:Intestine, Small / Q000293:injuries; D008099:Liver / Q000293:injuries; D008403:Mass Screening; D009017:Morbidity; D010179:Pancreas / Q000293:injuries; D010343:Patient Admission; D010808:Physical Examination; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D012680:Sensitivity and Specificity; D013154:Spleen / Q000293:injuries; D014057:Tomography, X-Ray Computed; D017749:Total Quality Management / Q000458:organization & administration; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*