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May 2012, Volume 42 Number 5 , p 72 - 72


  • Vincent M. Vacca Jr. MSN, RN, CCRN


MS. N, 43, is transported to the ED by a friend. The day before, she slipped and fell to the floor at home, landing hard in the sitting position. Except for localized pain around the site of impact, she seemed uninjured at the time. This morning, Ms. N had lower back pain and pain in both legs that started in the buttocks and traveled down the back of her legs (sciatica). Her left leg was weaker than her right. She reports increased urinary frequency, incontinence, and feeling like she wasn't emptying her bladder completely. Ms. N also notes numbness of her perineum, buttocks, and posterior thighs (perineal or saddle paresthesia).On arrival to the ED, Ms. N's vital signs are: temperature, 98.8[degrees] F (37[degrees] C); heart rate, 90; respirations, 14; BP, 128/82; and SpO2, 98% on room air. Her upper extremity motor strength is 5/5 bilaterally, with normal sensation. Her left lower extremity motor strength is 3/5 and right lower extremity 4/5, and she has sensory deficits in her gluteal

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