At that point, direction of the President’s treatment was undertaken by Dr. Malcolm O. Perry, who arrived at trauma room 1 a few moments after the President.[C2-203] Dr. Perry noted the President’s back brace as he felt for a femoral pulse, which he did not find.[C2-204] Observing that an effective airway had to be established if treatment was to be effective, Dr. Perry performed a tracheotomy, which required 3 to 5 minutes.[C2-205] While Dr. Perry was performing the tracheotomy, Drs. Carrico and Ronald Jones made cutdowns on the President’s right leg and left arm, respectively, to infuse blood and fluids into the circulatory system.[C2-206] Dr. Carrico treated the President’s known adrenal insufficiency by administering hydrocortisone.[C2-207] Dr. Robert N. McClelland entered at that point and assisted Dr. Perry with the tracheotomy.[C2-208] Dr. Fouad Bashour, chief of cardiology, Dr. M. T. Jenkins, chief of anesthesiology, and Dr. A. H. Giesecke, Jr., then joined in the effort to revive the President.[C2-209] When Dr. Perry noted free air and blood in the President’s chest cavity, he asked that chest tubes be inserted to allow for drainage of blood and air. Drs. Paul C. Peters and Charles R. Baxter initiated these procedures.[C2-210] As a result of the infusion of liquids through the cutdowns, the cardiac massage, and the airway, the doctors were able to maintain peripheral circulation as monitored at the neck (carotid) artery and at the wrist (radial) pulse. A femoral pulse was also detected in the President’s leg.[C2-211] While these medical efforts were in progress, Dr. Clark noted some electrical activity on the cardiotachyscope attached to monitor the President’s heart responses.[C2-212] Dr. Clark, who most closely observed the head wound, described a large, gaping wound in the right rear part of the head, with substantial damage and exposure of brain tissue, and a considerable loss of blood.[C2-213] Dr. Clark did not see any other hole or wound on the President’s head. According to Dr. Clark, the small bullet hole on the right rear of the President’s head discovered during the subsequent autopsy “could have easily been hidden in the blood and hair.”[C2-214]