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FIVE YEARS ago a tracheotomy was performed "out of desperation" on a patient in the Cincinnati General Hospital who was practically moribund as the result of a crushing injury of the thorax. When the operation was performed, this obese patient was having labored, painful, and shallow respirations; he was deeply cyanotic and extremely apprehensive and evidenced striking paradoxical movements of his injured anterior thoracic wall. Almost immediately after the operation, his respirations became slower and much less painful, his color improved rapidly, his anxiety disappeared, and, what was remarkable to all observers, the paradoxical movements of his chest wall practically ceased. All these phenomena occurred despite the fact that aspiration of his tracheobronchial tree produced little in the way of blood or secretions. To our amazement the patient recovered. This striking result encouraged us to treat subsequent cases of crushed chest by means of tracheotomy on an empiric basis but
CARTER BN, GIUSEFFI J. FURTHER EXPERIENCES WITH TRACHEOTOMY IN MANAGEMENT OF CRUSHING INJURIES OF CHEST. AMA Arch Surg. 1954;69(4):483-487. doi:10.1001/archsurg.1954.01270040039007