Kennedy Resuscitation Report
Dr. M. T. Jenkins’s resuscitation report concludes the emergency treatment of President Kennedy. The intermittent positive pressure breathing apparatus was exchanged for an anesthesia machine to better control artificial ventilation. Doctors Akin and Giesecke assisted with the change from orotracheal to tracheostomy tube, while Doctors Hunt and Giesecke connected a cardioscope to assess cardiac activity. The emergency room cart was placed in Trendelenburg position, a venous cutdown was performed on the right saphenous vein, and additional IV fluids and blood were administered. By approximately 1245, external cardiac massage continued under Doctor Clark with a palpable peripheral pulse, but no electrocardiographic evidence of cardiac activity was present. Examination revealed a massive right temporal and occipital laceration with extensive skull defect, herniation and laceration of brain tissue, and protrusion of the cerebellum. Fragmented brain sections were found on the drapes. Restoration of adequate cardiac compression produced a great flow of blood from the cranial cavity, indicating severe vascular damage. Despite expeditious and efficient resuscitation efforts, the magnitude of cranial and intracranial damage proved irreversible. President Kennedy was pronounced dead at 1300.
Connally Thoracic Operative Record
Dr. Robert Shaw’s operative record dated 11-22-63 documents Governor John Connally’s thoracic surgery in Room 220. The pre-operative and post-operative diagnoses were gunshot wound of the chest with comminuted fracture of the fifth rib, with post-operative findings adding laceration of the right middle lobe and hematoma of the lower lobe. The operation (thoracotomy, removal of rib fragment, and wound debridement) ran from 1335 to 1520 under general anesthesia administered by Dr. Giesecke. In the emergency room, a sucking right chest wound had been partially controlled by occlusive dressing, and a tube had been placed through the second interspace in the mid-clavicular line connected to a water-seal bottle to evacuate the pneumothorax and hemothorax. Examination revealed the entrance wound just lateral to the right scapula near the axilla, with the missile shattering approximately ten cm of the lateral and anterior portion of the right fifth rib before exiting below the right nipple. The ragged fifth rib ends were cleaned with a rongeur, and the pleural cavity was opened widely with a self-retaining retractor. Approximately 200 cc of clot and liquid blood were removed. The middle lobe had a linear rent with an open bronchus; this was repaired with running sutures of #000 chromic gut rather than removing the lobe. A laceration in the engorged lower lobe was closed with a single suture of #3-O chromic gut. Drains were placed in the second interspace midclavicular line and through a stab wound in the eighth interspace posterior axillary line, both connected to water-seal bottles. The diaphragm was found uninjured, with no evidence of mediastinal injury. Penicillin and Streptomycin were instilled into the wound before closure with chromic gut sutures and black silk skin sutures. Patient condition was satisfactory.
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