May 2022

REHABILITATION

COMPLEX CASE: MULTIPLE TRAUMAS FROM TORNADO

In summer 2021, a tornado hit Chicago's western suburbs. For one patient, this event led to multiple traumas and complications. Nelson M. McLemore III, MD, physiatrist at Northwestern Medicine Marianjoy Rehabilitation Hospital, shares his experience with this complex case. 

Q: Tell us about your patient and the injuries she sustained during the tornado. 
A: The patient was a 34-year-old female and 28 weeks pregnant. During the tornado, a tree crashed through her window while she was asleep, crushing her side and neck and causing multiple traumas. 

Q: What initial care did she receive, and for what complications?
A: The patient was rushed to a level 1 trauma center, where an ultrasound revealed fetal demise. She was then transferred to another center for higher level care, where she stayed from June 21 - July 31, 2021.

Upon arrival, she was suffering bleeding from the neck and upper chest, blood in the chest cavity, a collapsed lung and no blood flow through major arteries to the upper part of the body. She was in need of a chest tube. 

She also required a craniotomy due to bilateral stroke in the cerebellum, parietal lobe, localized edema and shift in the brain from swelling. 

Additional injuries and complications included a blood clot in the leg, rib fracture, displaced cervical fracture, bilateral fractures of cervical region between sixth and first thoracic vertebrae (among other thoracic fractures) and multiple spinal fractures. She required a vent, tracheotomy and g tube for respiratory pain. 

Furthermore, she experienced complications with antibiotics, contracted C. diff and was seen by orthopaedic surgeons for a broken scapula and clavicle. 

Q: What did you observe when the patient arrived at Marianjoy Rehabilitation Hospital? 
A: The patient arrived at Marianjoy Rehabilitation Hospital on July 31, 2021. She was disoriented and had a brachial plexus injury. Her arm was completely flaccid and paralyzed. She needed assistance with all self care, could not sit up and was functionally devastated.

The patient received inpatient treatment until September 3, 2021, after which she was discharged to for home health care at her mother's house. 

Q: When did you begin treating the patient, and what progress has she made?
A: I began treating the patient as an outpatient after September 3, 2021. The patient is now able to move her arm, but still cannot close her hand. She is able to propel her wheelchair and put her own braces on. She is working on transferring herself from the ground to a standing position so that we can begin pool therapy, and she can also do limited walking using a wide based quad cane. This is amazing progress from where her journey began, and she continues to improve. 

Q: What is the latest update on the patient? 
A: The patient plans to continue home exercises over the summer, and then resume more extensive outpatient therapy at Marianjoy Rehabilitation Hospital in August 2022. The patient is very motivated and has remarkable, inspirational willpower, and I look forward to seeing her continue to improve.
Nelson M. McLemore III, MD, physiatrist at Northwestern Medicine Marianjoy Rehabilitation Hospital

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