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East and Central African Journal of Surgery
Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
ISSN: 1024-297X EISSN: 1024-297X
Vol. 20, No. 1, 2015, pp. 32-38
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Bioline Code: js15005
Full paper language: English
Document type: Research Article
Document available free of charge
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East and Central African Journal of Surgery, Vol. 20, No. 1, 2015, pp. 32-38
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Tertiary Trauma Survey: Evaluation of Missed Injuries at a Teaching Hospital in the Developing World.
Ogundele, O.J.; Ifesanya, A.O.; Oyewole, O.A. & Alonge, T.O.
Abstract
Background:
The gold standard in the care of the multiply injured is the prompt
identification of all life-threatening and associated injuries by using the Advanced Trauma
Life Support protocol (ATLS). The main objective of this study was to determine the
incidence of missed injuries in patients presenting
to our hospital and to identify the
primary contributing factors for each missed injury.
Methods:
An initial evaluation of our trauma registry data
for missed injuries in a 90%
population of trauma victims yielded an incidence of 12%. However, to determine the true
incidence of missed injuries, a prospective tertiary trauma survey was performed on all
injured patients admitted during a six month period. After the primary and secondary
surveys, all injuries and treatments were documented in the patients’ trauma medical
records. They were then re-examined immediately by
the senior orthopaedic registrars and
subsequently by the investigator.
Results:
Fifty-two missed injuries were found in 46 patients (10.5%) out of 438 cases.
Reasons for missed injuries include haemodynamic in
stability 3 (0.7%), head injury 17
(3.9%), low index of suspicion 5 (1.1%), lack of symptoms 6 (1.4%) and technical problems
12 (2.7%).
Conclusion:
There is a need to re-appraise our trauma care practice to reduce the
incidence of missed injuries.
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© Copyright - 2015 East and Central African Journal of Surgery
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