Errors in Emergency and Trauma Radiology: General Principles

Radiological diagnosis in general and in emergency and trauma setting demands quick decision-making under conditions of often substantial uncertainty, in which the availability of clinical information, and/or of prior imaging examinations, and/or the use of proper techniques, is often highly variable. Therefore, all such decisions have inherent error rates. While diagnostic errors are responsible for only approximately 10-15% of potentially preventable deaths in trauma center audits, as selective non-operative management has become increasingly feasible after abdominopelvic trauma, the accurate diagnosis of injuries requiring surgical or interventional management has become more imperative. As such, injuries missed on multi-detector computed tomography (MDCT) have the potential to result in more dire consequences. Radiologists are key members of the multidisciplinary trauma team, and play a critical role in not only diagnosing acute, potentially life-threatening injuries, but also in directing the clinical decision-making process toward appropriate surgical, interventional, or conservative management. Radiological errors in the emergency setting follow predictable patterns, including satisfaction of search errors and cognitive biases. By analyzing these patterns, individual and system-wide measures may be enacted to help prevent similar errors from being made in the future.