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  • Print publication year: 2008
  • Online publication date: January 2010

22 - Field Anesthesia and Military Injury

Summary

Objectives

Review the military environment and the constraints this imposes on resuscitation and anesthesia.

Review the issues in resuscitation of the ballistic casualty.

Discuss aspects of field anesthesia.

SUMMARY

Injuries from modern military munitions can be complex and devastating. Their management demands particular anesthetic and surgical skill sets including an understanding of time-critical injury. In addition, casualty management in the deployed military setting is subject to a number of threats and constraints that influence how care can be delivered. This chapter will consider the types of casualties that may present to the military provider; how the care is influenced by situational constraints, and suggest some anesthetic techniques that are appropriate for use in the field.

INTRODUCTION

Casualties presenting to the military anesthesiologist or anesthetist will broadly fall into a number of groups:

The ill, multiply injured casualty with time-critical injuries

The injured casualty needing surgery for wound care who is stable and can wait

Casualties needing follow-up procedures for wound and injury care

Routine problems such as appendectomies

Civilian patients (adult and child) falling into the above groups

All of these would have differing requirements in the setting of a large, well-resourced civilian hospital. The constraints of the military environment can mean they are managed very differently. This chapter is structured to try and separate the three chapter objectives, but in reality they are interwoven and some repetition is necessary between the different sections. The chapter starts with an overview of these constraints.

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