J Trauma
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This study prospectively evaluated the prevalence, clinical significance, and contributing factors to early missed injuries and the role of tertiary survey in minimizing frequency of missed injuries in admitted trauma patients. Missed injury, clinically significant missed injury, tertiary survey, and contributing factors were defined. Tertiary survey was conducted within 24 hours. ⋯ Secondary trauma survey is not a definitive assessment and should be supplemented by tertiary trauma survey.
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Editorial Comment
Neurologic dysfunction in the multiple organ dysfunction syndrome.
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Comparative Study
Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development.
Whereas organized trauma care systems have decreased trauma mortality in the United States, trauma system design has not been well addressed in developing nations. We sought to determine areas in greatest need of improvement in the trauma systems of developing nations. ⋯ The majority of deaths occur in the prehospital setting, indicating the importance of injury prevention in nations at all economic levels. Additional efforts for trauma care improvement in both low-income and middle-income developing nations should focus on prehospital and emergency room care. Improved emergency room care is especially important in middle-income nations which have already established a basic EMS.