@article{ref1,
title="Injuries missed during initial assessment of blunt multi-system trauma patients",
journal="Proceedings: Association for the Advancement of Automotive Medicine Annual Conference",
year="1993",
author="Rizoli, S. B. and Sharkey, P. W. and McLellan, B. A. and Boulanger, B. R.",
volume="37",
number="",
pages="255-262",
abstract="Initial management in trauma involves resuscitation and detection of injuries. Despite efforts, some injuries are missed. A review of 432 adult blunt trauma patients demonstrated that 59 (13.6%) had 74 missed injuries. Missed injuries were those recognized during hospitalization but not identified during resuscitation. Most missed injuries were fractures (83.8%). Once detected, 40% required a change in therapy, including surgery. Twenty-eight percent were diagnosed after extubation or recovery of consciousness and 25 % were never detected clinically. Radiologists diagnosed 28% of injuries by reviewing admission radiographs. Repeated physical examination, high suspicion and attention to complaints are essential in detecting missed injuries.<p />",
language="",
issn="1540-0344",
doi="",
url="http://dx.doi.org/"
}