July 2014 critical care case of the month: there is still a role for physicial examination

• Main Author: Raschke RA
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2014-07-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: trauma; upper extremity weakness; CT angiogram; neck; neurologic disease; central cord syndrome; physical examination; magnetic resonance imaging; nurse; shoulder pain
• Online Access: http://www.swjpcc.com/critical-care/2014/7/2/july-2014-critical-care-case-of-the-month-there-is-still-a-r.html

No abstract available. Article truncated at 150 words. History of Present Illness: A 90 yr old woman was the seatbelt-restrained driver in a low speed frontal motor vehicle collision with airbag deployment, after she accidentally hit the gas instead of the brake. In the emergency room, the patient’s main complaint was right shoulder pain. On ER physical exam, she had sternal ecchymosis consistent with “seatbelt sign”. Her right shoulder was said to be tender, but the mechanism of injury to the right shoulder was unclear since her drivers-side seatbelt would been in contact with her left rather than right shoulder. Her right upper extremity was said to be “weak secondary to pain”. Further neurological examination was noted to be difficult due to “patient crying out in pain and anxiety”, but it was noted that she could lift both legs off the bed. Her left knee was echymotic. Cardiac auscultation revealed irregularly irregular rhythm. PMH: Chronic atrial fibrillation; Coronary...