Trauma: Knife Wounds - What Lies Beneath

Course overview

Knife wounds are common presentations in emergency departments and trauma settings. It is critical for healthcare providers to approach stab wounds to the axillary and gluteal areas with caution and a high degree of vigilance. The deceptive nature of these wounds, where small or seemingly superficial injuries can mask underlying damage to deeper structures, necessitates a systematic and comprehensive evaluation. Unfortunately, there are instances where healthcare providers overlook these deep injuries, leading to potential complications and adverse outcomes for patients. Errors and omissions in wound care are a frequent cause of malpractice litigation for emergency and other acute care providers. In this activity, we explore cases where deep injuries were overlooked, discuss diagnostic pitfalls and challenges, provide strategies for preventing diagnostic error, and outline best practices for the assessment and management of knife wounds. After completing this activity, providers/members of the healthcare team should be able to: recognize the deceptive nature of axillary and gluteal stab wounds, understanding that deep injuries can occur even with seemingly minor wounds; incorporate information about the mechanism of injury into the evaluation and documentation for patients with axillary and gluteal stab wounds; create a standard and comprehensive approach to the evaluation of patients with axillary and gluteal stab wounds that includes obtaining a detailed history, performing a systematic physical examination, and utilizing appropriate imaging studies when indicated in order to accurately assess the depth and potential damage to vital structures; and implement appropriate management strategies for axillary and gluteal stab wounds.