Missed injuries: a case of trauma hide and seek.

The incidence of missed injuries in the trauma population has been reported as low as 2% and as high as 50%. Missed injuries can lead to serious complications and even death. A variety of factors lead to missed injuries: instability of the patient's condition, alterations in the patient's level of consciousness, health care provider inexperience, radiologic errors, technical errors, and admission to an inappropriate physician service. The most common type of missed injuries are musculoskeletal injuries, although missed injury occurs with head, chest, abdominal, spinal, and neurovascular trauma. Strategies such as repeat physical examinations, implementation of protocols for trauma management, and organization of a forum for discussion of errors are methods to decrease missed injuries.