Mr. Specter. Would you continue to describe your observations of the President?
Dr. Carrico. His—the President's color—I don't believe I said—he was an ashen, bluish, grey, cyanotic, he was making no spontaneous movements, I mean, no voluntary movements at all. We opened his shirt and coat and tie and observed a small wound in the anterior lower third of the neck, listened very briefly, heard a few cardiac beats, felt the President's back, and detected no large or sucking chest wounds, and then proceeded to the examination of his head. The large skull and scalp wound had been previously observed and was inspected a little more closely. There seemed to be a 4–5 cm. area of avulsion of the scalp and the skull was fragmented and bleeding cerebral and cerebellar tissue. The pupils were inspected and seemed to be bilaterally dilated and fixed. No pulse was present, and at that time, because of the inadequate respirations and the apparent airway injury, a cuffed endotracheal tube was introduced, employing a larynzo scope. Through the larynzo scope there seemed to be some hematoma around the larynx and immediately below the larynx was seen the ragged tracheal injury. The endotracheal tube was inserted past this injury, the cuff inflated, and the tube was connected to a respirator to assist the inadequate respiration. At about this point the nurse reported that no blood pressure was obtained.
Mr. Specter. Dr. Carrico, with respect to this small wound in the anterior third of the neck which you have just described, could you be any more specific in defining the characteristics of that wound?
Dr. Carrico. This was probably a 4–7 mm. wound, almost in the midline, maybe a little to the right of the midline, and below the thyroid cartilage. It was, as I recall, rather round and there were no jagged edges or stellate lacerations.
Mr. Specter. You said you felt the President's back?
Dr. Carrico. Yes.
Mr. Specter. Would you describe in more detail just what the feeling of the back involved at that time?
Dr. Carrico. Without taking the time to roll him over and look or to wash off the blood and debris, and while his coat and shirt were still on his arms—I just placed my hands at about his beltline or a little above and by slowly moving my hands upward detected that there was no large violation of the pleural cavity.
Mr. Specter. Why did you not take the time to turn him over?
Dr. Carrico. This man was in obvious extreme distress and any more thorough inspection would have involved several minutes—well, several—considerable time which at this juncture was not available. A thorough inspection would have involved washing and cleansing the back, and this is not practical in treating an acutely injured patient. You have to determine which things, which are immediately life threatening and cope with them, before attempting to evaluate the full extent of the injuries.