SAFE TRANSPORT FOR THE UNCONSCIOUS PATIENT

To the Editor:— I read Dr. Flagg's communication on "Safe Transport for the Unconscious Patient" in The Journal, February 17, with great interest because only last week I encountered a very similar case. At 5 p. m. on February 14 I was called to see a married woman aged 28 who was sinking rapidly. Forty hours previously she presented symptoms and signs plus spinal fluid changes of a subarachnoid hemorrhage, and since that time she had been semiconscious, rousing at intervals. When I arrived at the home her husband was applying artificial respiration, there being no voluntary effort; her radial pulse was barely felt at 120 and her heart sounds were feeble. A lumbar puncture was immediately done and circulatory stimulants were given. An ambulance was called and arrangements were made to place the patient in a Drinker respirator in a Syracuse hospital. The ambulance arrived at 8: 15 and the patient was placed in it and, escorted by state police, carried a distance of 35 miles through a blinding snowstorm to the hospital, which was reached at 10:45. All this time artificial respiration was being maintained by four persons taking turns in the ambu lance. The patient was immediately placed in the respirator after being placed on a hospital stretcher and taken upstairs in an elevator; she survived for three hours in it. Autopsy confirmed the diagnosis, there being a rent in an aneurysm of the