Caio Zamboni 1 ,Alexandre Maris Yonamine 2 ,Carlos Eduardo Nunes Faria 2 ,Marco Antonio Machado Filho 2 ,Ralph Walter Christian 2 ,Marcelo Tomanik Mercadante 3


You are watching: When is the tertiary survey completed for a trauma patient

Affiliations

1 Orthopaedics and also Traumatology department of Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil. Electronic address: caiozamboni
hotmail.com. 2 Orthopaedics and also Traumatology department of Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil. 3 Santa Casa de São Paulo clinical School and also Orthopaedics and Traumatology room of Irmandade da Santa Casa de Misericóridia de São Paulo, Brazil.
Caio Zamboni 1 ,Alexandre Maris Yonamine 2 ,Carlos Eduardo Nunes Faria 2 ,Marco Antonio Machado Filho 2 ,Ralph Walter Christian 2 ,Marcelo Tomanik Mercadante 3

Affiliations

1 Orthopaedics and Traumatology department of Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil. Electronic address: caiozamboni
hotmail.com. 2 Orthopaedics and Traumatology department of Irmandade da Santa Casa de Misericóridia de São Paulo, São Paulo, Brazil. 3 Santa Casa de São Paulo clinical School and also Orthopaedics and also Traumatology room of Irmandade da Santa Casa de Misericóridia de São Paulo, Brazil.

Introduction: clinical personnel in trauma centres in several countries have realised the undiagnosed injuries space common and are now focussing their fist on reducing the incidence of these injuries. Tertiary inspection is a simple and easy method to resolve the concern of undiagnosed injuries in trauma patients. Tertiary survey is composed of reevaluating patient 24 hrs after join by way of one anamnesis protocol, physical examination, evaluation of security tests and request for brand-new tests when necessary.

Objective: To show the importance of tertiary inspection in trauma patients for diagnosing injuries undetected at the time of early survey.

Methods: A standardised protocol was offered to do a prospective observational research with patient admitted through the emergency department, room of Orthopaedics and Trauma, Santa Casa de São Paulo. The patients were reevaluated 24 hours after join or ~ recovering consciousness. Brand-new physical examinations to be performed, test performed on admission were reassessed and brand-new tests to be requested, once necessary.

Results: in between February 2012 and also February 2013, 526 patients to be evaluated, 81 (15.4%) were polytraumatised, and 445 (84.6%) had actually low-energy trauma. A complete of 57 new injuries were diagnosed in 40 patients, 61.4% the which impacted the lower limb. Diagnosis that 11 brand-new injuries (19.3%) resulted in changes in procedure.

Conclusion: The applications of the protocol for tertiary survey proved to be easy, inexpensive and also beneficial to patient (particularly polytraumatised patients) since it allowed identification of necessary injuries the were not detected on admission in a large group of patients.


Keywords: delayed diagnosis; Diagnostic errors; multiple trauma; Neglected diseases.



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