Presidency

TRAUMA ROOM ONE: REVISITED

by Russell Kent

By Russell Kent, The Assassination Chronicles Vol. 1, Issue 4; Dec '95

A companion piece to: What What Did the Parkland Doctors Really Say?

Parkland Hospital Trauma Room One

Recently the Dealey Plaza U.K. group sponsored a presentation showing the medical personnel in Trauma Room one. What follows is a report of that presentation, which tried to show three things:

    1. The number of doctors attending the President
    2. The order of arrival of these doctors (important for understanding what they might have seen of the throat wound before/after the tracheotomy)
    3. The procedures carried out by the doctors.

I used only the published literature, so at times I took an informed guess ( I have a BSC in Physiology and spent two years doing cardiovascular research at St. Thomas' Hospital, London). Also, I couldn't place some doctors who were obviously there (and are on Brad Parker's list) as they didn't testify to the WC, have not been interviewed, or just were not specific enough about where they were or what they did.

This is, therefore, a reconstruction of 17 doctors who attended the President for more than a few minutes and their relative positions around the table. I am not suggesting that the doctors didn't move around or that the procedures were carried out simultaneously; I'm attempting a snapshot.

placement diagram
Note: This diagram is menat to show where the doctors recalled they stood. It is not meant to show all the medical personnel were in these spots at one time.

Above JFK's head -
(1) Hunt
(2) Giesecke
(3) Jenkins (anesthetists position)

Left of JFK's neck -
(4) Perry, performed a tracheotomy
(5) Carrico (attended to throat wound; "Dr. Carrico inserted a cuffed endotracheal tube past the injury, inflated the cuff, and connected it to a Bennett machine to assist in respiration." WC)
(6) McClelland (held the retractor to keep the tissue open as Perry and Baxter performed a tracheotomy; he also stood at position 2)
Left arm -
(7) Jones (did left arm cutdown and left chest drain)
Right or left chest -
(8) Clark,
(9) Bashour &
(10) Seldin
Left leg -
(11) Curtis,
(12) White & (13)Zedelitz (did the left leg cutdown)
Right leg -
(14) Crenshaw
(15) Salyer & Carrico (did right leg cutdown)
Dr. Carrico treated the President's known adrenal insufficiency by administering hydrocortisone. Right chest -
(16) Peters (inserted chest drain
(17) Baxter (inserted right chest drain).

Russell Kent has a Bachelor of Science degree in Physiology from the University of London. After graduating in 1983, Russell did two years medical research at St. Thomas' Hospital, London in the Department of Applied Physiology sponsored by the Department of Anaesthetics and the British Heart Foundation. He became a technical author in 1985 and now manages a documentation consultancy based in the UK.

Article update and Graphic by Debra Conway


Drs. Listed in Trauma Room One from various sources* including Warren Commission Hearings Volume 6:

Dr. Gene Akin
Dr. Fouad Bashour
Dr. Charles Baxter
Dr. James Carrico
Dr. Kemp Clark
Dr. Charles Crenshaw
Dr. Richard Brooks Dulany (mentioned by Jenkins)
Dr. A. H. Giesecke, Jr.
Dr. Robert Grossman
Dr. Jackie H. Hunt
Dr. M. T. Jenkins
Dr. Ronald Jones
Dr. Robert McClelland
Dr. Malcolm Perry
Dr. Paul Peters
Dr. Kenneth Salyer

Diana Hamilton Bowron

Margaret M. Henchliffe (First medical personel in Trauma Room 1, in the room with Aubrey Rike as President Kennedy was placed in his coffin.)

Doris Mae Nelson

* See also: Dr. Ronald Jones/Medical Evidence


Report of the President's Commission on the Assassination of President Kennedy
Appendix 8: Medical Reports from Doctors at Parkland Memorial Hospital, Dallas, Tex.

This appendix (pages 516 through 537) reproduces COMMISSION EXHIBIT NO. 392, which includes:

* Dr. Kemp Clark's statement
* Parkland Memorial Hospital Admission Notes
* Statement concerning Resuscitative Efforts for President John F. Kennedy
* Parkland Memorial Hospital Operative Record for John Connally


Commission Exhibit No. 392
The President arrived in the Emergency Room at exactly 12:43 p. m. in his limousine. He was in the back seat, Gov. Connally was in the front seat of the same car, Gov. Connally was brought out first and was put in room two. President was brought out next and put in room one. Dr. Clark pronounced the President dead at 1 p. m. exactly. All of the President's belongings except his watch were given to the Secret Service. His watch was given to Mr. O. P. Wright. He left the Emergency Room, the President, at about 2 p. m. in an O'Neal ambulance. He awas put in a bronze colored plastic casket after being wrapped in a blanket and was taken out of the hospital. He awas removed from the hospital. The Gov. was taken from the Emergency Room to the Operating Room.

The President's wife refused to take off her bloody gloves, clothes. She did take a towel and wipe her face. She took her wedding ring off and placed it on one of the President's fingers.


Summary
The President arrived at the Emergency Room at 12:43 P. M., the 22nd of November, 1963. He was in the back seat of his limousine. Governor Connally of Texas was also in this car. The first physician to see the President was Dr. James Carrico, a Resident in General Surgery.

Dr. Carrico noted the President to have slow, agenal respiratory efforts. He could hear a heartbeat but found no pulse or blood pressure to be present. Two external wounds, one in the lower third of the anterior neck, the other in the occipital region of the skull, were noted. Through the head wound, blood and brain were extruding. Dr. Carrico inserted a cuffed endotracheal tube. While doing so, he noted a ragged wound of the trachea immediately below the larynx.

At this time, Dr. Malcolm Perry, Attending Surgeon, Dr. Charles Baxter, Attending Surgeon, and Dr. Ronald Jones, another Resident in General Surgery, arrived. Immediately thereafter, Dr. M. T. Jenkins, Director of the Department of Anesthesia, and Doctors Giesecke and Hunt, two other Staff Anesthesiologists, arrived. The endotracheal tube had been connected to a Bennett respirator to assist the President's breathing. An Anesthesia machine was substituted for this by Dr. Jenkins. Only 100% oxygen was administered.

A cutdown was performed in the right ankle, and a polyethylene catheter inserted in the vein. An infusion of lactated Ringer's solution was begun. Blood was drawn for type and crossmatch, but unmatched type "O" RH negative blood was immediately obtained and begun. Hydrocortisone 300 mgms was added to the intravenous fluids.

Dr. Robert McClelland, Attending Surgeon, arrived to help in the President's care. Doctors Perry, Baxter, and McClelland began a tracheostomy, as considerable quantities of blood were present from the President's oral pharynx. At this time, Dr. Paul Peters, Attending Urological Surgeon, and Dr. Kemp Clark, Director of Neurological Surger, arrived. Because of the lacerated trachea, anterior chest tubes were place in both pleural spaces. Thiese were connected to sealed unerwater drainage.

Neurological examination revealed the President's pupils to be widely dialted and fixed to light. His eyes were divergent, being deviated outward; a skew deviation from the horizontal was present. Not deep tendon reflexes or spontaneous movements were found.

There was a large wound in the right occipito-parietal region, from which profuse bleeding was occurring. 1500 cc. of blood were estimated on the drapes and floor of the Emergeny Operating Room. There was considerable loss of scalp and bone tissue. Both cerebral and cerebellar tissue were extruding from the wound.

Further examination was not possible as cardiac arrest occurred at this point. Closed chest cardiac massage was begun by Dr. Clark. A pulse palpable in both the carotid and femoral arteries was obtained. Dr. Perry relieved on the cardiac massage while a cardiotachioscope was connected. Dr. Fouad Bashour, Attending Physician, arrived as this was being connected. There was electrical silence of the President's heart.

President Kennedy was pronounced dead at 1300 hours by Dr. Clark.

Kemp Clark, M. D.
Director
Service of Neurological Surgery
KC:aa


 

Page 529

THE UNIVERSITY OF TEXAS
SOUTHWESTERN MEDICAL SCHOOL
DALLAS

November 22, 1963
1630

To: Mr. C. J. Price, Administrator Parkland Memorial Hospital

From: M. T. Jenkins, M.D., Professor and Chairman Department of Anesthesiology

Subject: Statement concerning resuscitative efforts for President John F. Kennedy

Upon receiving a stat alarm that this distinguished patient was being brought to the emergency room at Parkland Memorial Hospital, I dispatched Doctors A. H. Giesecke and Jackie H. Hunt with an anesthesia machine and resuscitative equipment to the major surgical emergency room area, and I ran down the stairs. On my arrival in the emergency operating room at approximately 1230 I found that Doctors Carrico and/or Delaney had begun resuscitative efforts by introducing an orotracheal tube, connecting it for controlled ventilation to a Bennett intermittent positive pressure breathing apparatus. Doctors Charles Baxter, Malcolm Perry, and Robert McClelland arrived at the same time and began a tracheostomy and started the insertion of a right chest tube, since there was also obvious tracheal and chest damage. Doctors Paul Peters and Kemp Clark arrived simultaneously and immediately thereafter assisted respectively with the insertion of the right chest tube and with manual closed chest cardiac compression to assure circulation.

For better control of artificial ventilation, I exchanged the intermittent positive pressure breathing apparatus for an anesthesia machine and continued artificial ventilation. Doctors Gene Akin and A. H. Giesecke assisted with the respiratory problems incident to changing from the orotracheal tube to a tracheostomy tube and Doctors Hunt and Giesecke connected a cardioscope to determine cardiac activity.

During the progress of these activities, the emergency room cart was elevated at the feet in order to provide a Trendelenburg position, a venous cutdown was performed on the right saphenous vein, and additional fluids were begun in a vein in the left forearm while blood was ordered from the blood bank. All of these activities were completed by approximately 1245, at which time external cardiac massage was still being carried out effectively by Doctor Clark as judged by a palpable peripheral pulse. Despite these measures there was no electrocardiographic evidence of cardiac activity.
Page 530

Mr. C. J. Price, Administrator
November 22, 1963
Page 2 - Statement concerning resuscitative
efforts for President John F. Kennedy

These described resuscitative activities were indicated as of first importance, and after they were carried out attention was turned to all other evidences of injury. There was a great laceration on the right side of the head (temporal and occipital), causing a great defect in the skull plate so that there was herniation and laceration of great areas of the brain, even to the extent that the cerebellum had protruded from the wound. There were also fragmented sections of brain on the drapes of the emergency room cart. With the institution of adequate cardiac compression, there was a great flow of blood from the cranial cavity, indicating that there was much vascular damage as well as brain tissue damage.

It is my personal feeling that all methods of resuscitation were instituted expeditiously and efficiently. However, this cranial and intracranial damage was of such magnitude as to cause the irreversible damage. President Kennedy was pronounced dead at 1300.

Sincerely,

M. T. Jenkins, M.D.

 

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