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22 - Field Anesthesia and Military Injury

Published online by Cambridge University Press:  18 January 2010

Peter F. Mahoney
Affiliation:
Military Critical Care, Royal Centre for Defence Medicine, Birmingham, United Kingdom
Craig C. McFarland
Affiliation:
Department of Anesthesiology, Uniformed Services, University of the Health Sciences, Bethesda, Maryland
Charles E. Smith
Affiliation:
Case Western Reserve University, Ohio
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Summary

Objectives

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

  2. Review the issues in resuscitation of the ballistic casualty.

  3. 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:

  1. The ill, multiply injured casualty with time-critical injuries

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

  3. Casualties needing follow-up procedures for wound and injury care

  4. Routine problems such as appendectomies

  5. 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.

Type
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Trauma Anesthesia , pp. 343 - 359
Publisher: Cambridge University Press
Print publication year: 2008

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  • Field Anesthesia and Military Injury
    • By Peter F. Mahoney, Military Critical Care, Royal Centre for Defence Medicine, Birmingham, United Kingdom, Craig C. McFarland, Department of Anesthesiology, Uniformed Services, University of the Health Sciences, Bethesda, Maryland
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.025
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Field Anesthesia and Military Injury
    • By Peter F. Mahoney, Military Critical Care, Royal Centre for Defence Medicine, Birmingham, United Kingdom, Craig C. McFarland, Department of Anesthesiology, Uniformed Services, University of the Health Sciences, Bethesda, Maryland
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.025
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Field Anesthesia and Military Injury
    • By Peter F. Mahoney, Military Critical Care, Royal Centre for Defence Medicine, Birmingham, United Kingdom, Craig C. McFarland, Department of Anesthesiology, Uniformed Services, University of the Health Sciences, Bethesda, Maryland
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.025
Available formats
×