Injury
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A 34-year-old man was stabbed in the heart with the loss of all signs of life at the site of the incident. A resuscitative thoracotomy was performed at the roadside rather than transport a lifeless patient to hospital. ⋯ He recovered and was discharged at 25 days with normal neurology and mentation. Pre-hospital thoracotomy on a patient who had lost signs of life following a penetrating chest wound is an alternative to a "scoop and run' policy.
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Eighty missed musculoskeletal injuries in 51 patients in King Khalid University Hospital are analysed. The diagnostic failure rate was 0.6 per cent of all injured patients seen in the emergency room and 6 per cent of admissions under orthopaedic care. ⋯ In 48 of these patients (60 per cent) there were one or more complaints related to the missed injury. Factors responsible for inadequate diagnosis included breaking of clinical routine, inadequate clinical examination, ignoring the patient's complaints and positive physical signs, and lack of or misinterpreted and inadequate X-rays.