29.12.2006
PARALIZED-BETWEEN LIFE AND DEATH
PARALIZED-BETWEEN LIFE AND DEATH
09.21.75 2 0'clock
Intensive care:
Specialist-examination on Olafur Thor Eiriksson, Haholt 5, Keflavík.--Patient no. 535-457.
Examination: Pat. is comatou (unconscious), no signs of injury over neuracranium, X-ray of cranium (head) - fract (unbroken).
Patient has a broken jaw.
The pupils are both quite narrow, but there is some skew-deviation Pat. is decorticate bilat.
Pat. has a contusion on one lung and has aspirered. Blood pressure 130/80, pulse 90.
ECHO: Normal.
Result: Pat. has contusio on spinalcord, no sign of intracranial -cerebral hemorrhage as yet.
Recommend: Decadon 4 mg. x 4 ( has had. 10 Keepiquid in the distance
1000- 1400 ml. (glukose). Tracheotoma.
Pat. weighs 70 kg. on arrival.
Will keep tabs on pat.
B. Hannesson
09.21.75 2.30
X-ray- ward Intensive care Borgarspitali:
Doctor: Magnus
CERVICAL VERTEBRAE: A fracture can be seen on the transvers process on the right side on C:VI and in addition to this, one notices on an x-ray picture
that the first rib on the right side is also fractured and there is a piece missing from under that rib ca. cm. in diameter. No contortion can be seenin the cervical vertebrae and no fractures can be seen on profile. CRANIUM: No fractures seen. Sella turcica looks allright and cellu-system and sinuses seem well-filled with air.
LOWER JAW: There's a fracture on right side a cm. behind angulus and by the canine tooth. The fractures seem to go right through the jaw and the
bonepart being loose.. LUNGS: On the right side in thorax above apex a liquid can been seen down to the VI. rib and the distance between the lung and the thorax-wall
primarily by apex a wide 2 cm. In addition to this a compression is fromboth lungs that could allude to an aspiration. On the left side a lungstructure can't be seen in a periferin, which could allude to a pneumothorax even though a clear lungstripe can't be seen.
ABDOMEN scheme: No additional liquid can be detected nor any expansion of organs in the abdomen, but two X-ray shadows can be seen at either of the two connections sacro-iliaca. Looks like an X-ray contrast. In addition to that one thing can be mentioned, that the pediklin on L:IV on the right side seems fractured and the patient has spina bifida occulta (a little split spinal) on L:V - S:I
where an obvious split in transvers processi (vertebra) on these connections. PELVIS: Fractures or other patol. variations aren't diagnosed in this examination.
JF/_m
09.21.75
Doctors of Surgeon- and Neuroward:
A twenty year old man who came here after an accident that occurred in Svinahraun shortly before arriving to the hospital, at 2,30. He's totally unconscious, though he reacts in a very deprecated way to a painful stimuli and probably has brain contusio. The pupils are even and fairly
co-ordinated and he has a stable pulse and tensio.
The mandibula is fractured in two places on the right side and quite large haematoma, that has sank down the neck on the right side.
Much crepitation can be heard during his respiration and therefore much blood-colored liquid needs to be sucked from his mouth and throat, probably originated in the lungs.
There was suspision of a haemothorax (blood in chest) on the left side on X-rays and therefore a thoraxdrain is put down his throat shortly after arrival on Intensive care, but no blood has come out. A probable cause is a contusio on the lung itself.
Furthermore a tracheostomia was made shortly after the arrival and then a lot of blood came up from bronchi. The tracheostomiana was difficult because of much thyroideatissue lies over the trachea.
Supposedly his neck is broken? He has slight wounds scattered here and there on his body, mainly on his limbs.
He gets limited liquid, Decadron and Penbritin. A catheter is put on his penis and he is put in a monitor. Temperature encreases soon to 39_ C and therefore he gets a cooling mattress and asperin. His respiration seems fairly good and the crepi-tation deminished greatly posterior to the sucking of bloody slime through the tracheostomia-tube.
_._./as
9.23.75:
The patient's conditition is a little better, his temperature has been mostly normal without a cooling mattress the last 24 hours.
Patient has good respiration and his respirations-graph was almost normal when read yesterday. His movements were very spastical at first, has got lots of Valium intravenust (veins) lately, but a lesser amount yesterday than the day before and the last 24 hours he has not been spastical and seems a little lighter.
He gets Decadron inj. 4 mgr. x 4 and Penbritin 1 gr. x 4 and had his first liquid-food through a tube (sondumat) yesterday.
Still has a thoraxdrain and a tracheostomi.
_.M./go.
09.26.75:
An operation made by Sigurjon Olafsson, dentist.
DIAGNOSIS: Fractura mandibula dx. (fracture in a jawbone) on caninetooth-area. Fractura mandibula dx. on molararea. -the front fracture is open into mouth.
OPERATION-DIAGNOSIS: The ri. canine-tooth in the lower palate is removed in the beginning because it was quite loose in addition to the supposed greater risk of infection by keeping the tooth.
The mucous membrane in this area was then sewn together with chrom 0:3.
Wire-loops were now fastened onthe teeth in the upper gum both on both sides.
Then the alveolarbar was wired to the lower jaw's right side all the way to front fractureline.
Wires were then fastened loosely around the alveolarbar and isolated teeth on the left side. The lower jaw was then moved in occlusion with the upper jaw and all wires on the left side were thoroughly tightened.
Finally two wires on both sides were used to keep steady the interdental fixation between the lower and upper jaw. No complications.
- Sigurjon Olafsson/es
09.27.75.
City's Hospital's Intensive care X-ray ward:
CERVICAL VERTEBRAE, CONTROL: The fracture-line is unchanged compared to an earlier examination on 9.21.75. More injuries have not been discovered.
H_/e¾
09.30.75:
Situation similar these last days. Though he seems to have lost a little weight. The Thorax-drain has been closed with a clamp since yesterday, but a little sickle above the lung, perhabs making it possible to remove the drain tomorrow. Penbritin is no longer needed. The wires that eld the jaw together snapped, but got put together again this morning.
_._.J./bk.
10.01.75 kl. 9.05
X-ray-division of the Intensive care.:
LUNGS BEDPHOTO, CONTROL: Now only a small stripe can be seen on the pneumothorax perifert in the left thorax. Other wise status hasn't changed.
H_/e