Missed Injury--Decreasing Morbidity and Mortality: A Literature Review (Report‪)‬

Missed injuries are defined variously as injuries identified after the initial period of resuscitation (primary and secondary survey of Advanced Trauma Life Support[R]), although they may also be injuries identified after a defined time period after injury, such as 12 or 24 hours. (1,2) However, there is no absolute definition, since some missed injuries may present long after the traumatic event (e.g. penetrating injuries of the diaphragm presenting many months to years later as a hernia). Missed injury has been a source of concern to clinicians for many years, and the first series examining the influence of missed injury from South Africa was reported by Gordon in 1986. (3) While missed injury is not new, what is surprising is that injuries are missed even in developed countries with experienced units. (2,4)