207. “Completely wounded if any soldier ever was.”

Barnett, Harold O., S/Sgt. 35482924 Age 24 “K” Co 142nd
Injured 1100 hrs. 23 Oct. 44 Shell frag.
3rd Bn Aid Sta. 142 1315 hrs. Sulf. dressing & Tabs. M.S. gr 1/4
Co B. 111th Med Bn 1400 hrs.    
Clr. Sta 111th Med Bn 1445 hrs. 1 cc T.T.  
11th Field Hosp. 1500 hrs.    

Gen’l condition on admission poor. B.P. 40/0 P. 130 Shock. Abd. rigid++ moderate tenderness. ?Paralysis radial right.


Diagnosis: Shell fragment wds. multiple pen. and perf. abd., rt arm; rt. shoulder; rt and left buttocks; Lumbodorsal region; rt and left thighs; rt and left legs; left ankle sv.


Preop Rx. 1545 hrs 1 unit plasma. 1550 hrs. 1 unit plasma. 1600 hrs. 500 cc blood. 1645 hrs. 500 cc blood. 1700 hrs. B.P. 106/60 Xray of abd & chest. 1740 hrs. 500 cc blood. 1800 hrs. Penicillin 25,000 units.

Operation

1835 hrs. B.P. 88/50 P. 160 1000 cc 5% glucose in saline
1855 hrs. B.P. 92/48 P. 140 500 cc blood type A.
1920 hrs. B.P. --- P. 140 Surgery started.
1935 hrs. B.P. 110/44 P. 128  
1955 hrs. B.P. 88/38 P. 124 500 cc blood type A.
2005 hrs. B.P. 108/50 P. 128 500 cc blood type A.
2020 hrs. B.P. 110/56 P. 120  
2045 hrs. B.P. 112/50 P. 120  
2100 hrs. B.P. 90/50 --- Pt. turned on left side.
2115 hrs. --- P. 108 Pt. turned on back.
2130 hrs.     Spica 500 cc blood 0
2140 hrs.     Spica finished.

Endotracheal ether and 02. Abdominal exploration and surgery of thigh started. Capt. Kennedy and Major Madding, exploration; and Capt. Jergensen surgery of left femoral a & v. Abdomen explored thru high right rectus incision. Abdomen full of blood. Large perforating wd. of right lobe of liver. F.B. removed from pt. of exit over right dome of liver. Diaphragm neg. Remainder of exploration neg. One penrose drain led to large wound of liver. Second penrose drain led to Morison’s pouch. Both delivered thru a subcostal stab wd. 10 gms sulf into peritoneal cavity. Two retention sutures thru all layers. Abdomen closed in layers. Penetrating wd. over 11th rib right debrided. Rib had been fractured. Wd. did not suck. Closed to skin. Penetrating and perforating wds. of right scapular region debrided. One F.B. removed. Pen. & perf. wds. of right thigh and leg debrided. Capt. Jergensen secured common femoral thru small infra inguinal incision with tape. Superficial femoral artery and vein explored at junction of proximal and middle 1/3s and a laceration of the contiguous surfaces (3/4s) was found. Repaired transversely with 000 silk. Linear incision made below repair of artery and long (6") clot removed. F.B. which caused laceration of A & V entered postero medially and lodged subcutaneously lateral to vessels. Was removed thru sep. incision. A segmental periarterial sympathectomy done below site of injury to vessels. Two penetrating wds of left popliteal space medial aspect debrided. Medial Inf geniculate artery tied. Medial condyle site of complete fracture. Two F.B.’s removed from soft tissue--one F.B. removed from fractured medial condyle of femur, left. Wd. over medial aspect left ankle debrided. Posterior tibial artery had to be ligated. Wd over lumbo dorsal region at L1 debrided. F.B. removed. Pen wd. of rt. buttock debrided. F.B. deep to palpating finger but could not be removed. Perf. wd. of rt. arm debrided. Plain mesh gauze dressing to all wds. Hip spica applied. Lumb sympathetic block L 1,2,3,4. 2000 cc blood type A & 500 cc blood type O. At the time of debridement of left ankle wd. arterial blood was seen to flow from wd.

Additional diagnosis. F.C. complete medial condyle femur left; F.C. rib 11th right axillary line; Laceration superficial A. & R. left; Laceration posterior tibial A. left.

29 Oct. 44 Improvement. Uneventful up to this evening. Left foot will be lost. This evening soldier developed sudden respiratory difficulty, cyanosis, substernal sense of constriction B.P. 170/100 P. 160+.

Died.

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