Woman Thrown From Horse

A 53-year-old woman is brought to your facility complaining of right-side chest pain. Earlier this evening, while riding her horse, she was thrown off; the horse then fell on top of her. She denies any loss of consciousness. Most of her pain occurs when she inhales. The patient’s medical history is unremarkable. Her vital signs are: blood pressure, 148/87 mm Hg; heart rate, 100 beats/min; respiratory rate, 14 breaths/min; and O2 saturation, 100% with oxygen via nasal cannula. Primary survey reveals moderate tenderness to palpation along the right side of the patient’s chest, with associated crepitus. Some decreased breath sounds are noted on the right, along with crackles. She is moving all of her extremities and otherwise appears neurologically intact. A stat portable chest radiograph is obtained in the trauma bay before the patient is transported for CT scans. What is your impression?