ABSTRACT
This study quantified the types of extremity fractures most commonly missed on plain radiographs by pediatric emergency medicine specialists after an initial emergency department (ED) encounter. From February 2006 to June 2009, extremity radiographs obtained in a pediatric ED in which a radiologist categorized the ED attendings' read of normal as incorrect were tabulated. The authors also counted the total number of each type of radiograph completed when radiologists were unavailable. The percentage of each type of fracture missed was calculated based on the total number of missed fractures. It was found that a total of 220 fractures were missed during ED encounters in the study period. The most frequently missed fractures were of the hand phalanges (26.4%) followed by metatarsus (9.5%), distal radius (7.7%), tibia (7.3%), and phalanges of the foot (5.5%). Emergency physicians should be aware that the most commonly missed fractures were phalanges of the hand and metatarsal fractures.
Subject(s)
Diagnostic Errors/statistics & numerical data , Emergency Service, Hospital/statistics & numerical data , Extremities/diagnostic imaging , Extremities/injuries , Fractures, Bone/diagnostic imaging , Hospitals, Pediatric/statistics & numerical data , Adolescent , Child , Child, Preschool , Delayed Diagnosis/statistics & numerical data , Humans , Infant , Radiography , Retrospective Studies , Young AdultABSTRACT
Hemoglobinopathies are an uncommon cause of cyanosis and low oxygen saturation on pulse oximetry. However, when they do occur, they can present a complex clinical scenario for the emergency physician. We report the index case of a previously undescribed hemoglobinopathy that presented to the pediatric emergency department. The evaluation and management of the cyanotic/hypoxic child and review of hemoglobinopathies are presented here.
