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.