Dr. Perry. The condition of this area?
Mr. Specter. Yes, sir.
Dr. Perry. There was both blood, free blood and air in the right superior mediastinum. That is the space that is located between the lungs and the heart at that level.
As I noted, I did not see any underlying injury of the pleura, the coverings of the lungs or of the lungs themselves. But in the presence of this large amount of blood in this area, one would be unable to detect small injuries to the underlying structures. The air was indicated by the fact that there was some frothing of this blood present, bubbling which could have been due to the tracheal injury or an underlying injury to the lung.
Since the morbidity attendant upon insertion of an anterior chest tube for sealed drainage is negligible and the morbidity which attends a pneumothorax is considerable, I elected to have the chest tube put in place because we were giving him positive pressure oxygen and the possibility of inducing a tension on pneumothorax would be quite high in such instances.
Mr. Specter. What is pneumothorax?
Dr. Perry. Hemothorax would be blood in the free chest cavity and pneumothorax would be air in the free chest cavity underlying collapse of the lungs.
Mr. Specter. Would that have been caused by the injury which you noted to the President's trachea?
Dr. Perry. There was no evidence of a hemothorax or a pneumothorax through my examination; only it is sufficient this could have been observed because of the free blood in the mediastinum.
Mr. Specter. Were the symptoms which excited your suspicion causable by the injury to the trachea?