Unexpected, unsuspected and missed injuries in a paediatric trauma unit.

In a newly established trauma unit 12 282 patients were seen in 1 year, of whom 1 557 were admitted. Out of the total there was 0.3% of missed, unexpected or unsuspected injuries; this was 2.5% of ward admissions. These injuries are classified and analysed, highlighting the need for constant vigilance. Although the majority were orthopaedic injuries, the abdominal injury cases show that these can be more severe than clinically suspected.