Pearls and Pitfalls

  • Penetrating injuries made with a sharp object often look smaller due to the elasticity of the tissues.
  • If a weapon is seen, leave in place and inform the Police. It is important to avoid contaminating forensic evidence. Do not assume this weapon caused your patients injury [this may inadvertently provide incorrect information to downstream clinicians].
  • Knowing patterns of injury, while useful should not supersede or replace clinical assessment, nor radiological investigation.
  • Elderly or frail patients can sustain more severe injuries from seemingly low energy mechanisms.
  • Remember medical events (e.g. arrythmia, seizures etc) may have preceded or precipitated an apparently traumatic mechanism. Did the patient suffer a seizure or cardiac arrest prior to the car crash, or did the person suffer a traumatic cardiac arrest post impact? Clues from the scene such as non-deployed airbags, minimal exterior damage MAY suggest a medical event. This, of course, does not rule out traumatic injuries but can help guide direction of management.