257. “The kid pleaded with me to save it but it had to come off.”

Jeter, Cody (N.M.I.), Pvt.	20828464	Age 22	180th Inf.
Injured	1315 hrs.	20 Dec. 44	H.E.S.F.
1st Bn Aid Sta 180th Inf.	1330 hrs.		M.S. gr 1/4 in field
Coll Co C 120th Med Bn.			Splint
57th Field Hosp.	1715 hrs.		T.T. 1 cc

Gen’l condition on admission poor. Shock sv. B.P. 90/60 P. 120. Color extremely pale. Right foot cold & pale. No sensation--pain or pressure or position. Dorsales pedes & posterior tibial a’s pulseless.

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Diagnosis: S.F.W. perf. leg right w/ F.C.C. fibula & F.C. incomplete tibia. S.F.W. pen. and perf. leg left sv. Shock, secondary, sv.

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Preop Rx

1730 hrs.	B.P. 90/60	P. 120	250 cc plasma.
1740 hrs.	B.P. 90/60	P. 110
1800 hrs.	B.P. 86/58	P. 102
1815 hrs.	B.P. 96/60	P. 102	250 cc plasma
2000 hrs.	B.P. 110/72	P.	25,000 units Penicillin. Xray both legs

Operation

2015 hrs.	B.P. 100/60		Endotracheal E & O2. Plasma 500 cc
2035 hrs.	B.P. 70/40	P. 120	Turned on belly. 500 cc blood
2045 hrs.	B.P. 60/40	P. 120	Op. started. N.S. & G 1000 cc
2115 hrs.	B.P. 70/40	P. 120
2145 hrs.	B.P. 80/40	P. 110	Op. ended.
2200 hrs.	B.P. 120/70		Plasma discontinued (total 250 cc).

Pt. on face. Attempt at simple debridement with hope of saving limb was made. No viable muscle tissue was found bridging the wd. except a small portion of the anterior tibialis muscle. The anterior tibial A. had been severed. Was ligated with silk. Both posterior tibial A. and peroneal A. were also found to be severed--ligated. The fibula was missing for an extent of 6 inches in the wd. The tibia was incompletely fractured. The anterior leading edge was intact. It was obvious that attempt at saving the leg would lead to disaster so a debridement amputation was done at the proximal part of the wound. Wds. of left lg debrided. One F.B. removed. Large pieces of clothing removed from wd. Wd. irrigated with normal saline. Sulf. crystals to both legs. Traction plaster cast to right stump. Posterior plaster splint to left leg. 2 units plasma. 500 cc blood, type O (Pt. type A).

Dec. 21	500 cc blood.
Dec. 22	500 cc blood.
Dec. 24	500 cc
Dec. 26	500 cc
Dec. 27	Evacuated.

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