Anesthesia in the Field (Discussion to the Previous Papers in Section Six)

Extract

A major man-made disaster, like a nuclear attack, may suddenly reduce a highly developed country to very primitive conditions. The choice of anesthetics for the field depends on medical suitability, but, primarily upon a country's production possibilities in disaster conditions. Simple anesthesiological procedures must be preferred. Provisions are to be made for ketamine, atropine, narcotics (pethidine, morphine), in order to make possible intravenous/intramuscular anesthesia. For inhalation anesthesia, diethylether with a simple inhalation anesthesia apparatus is needed. Ether remains important for disaster conditions, because of its relative safety in less experienced hands and because its production is both cheap and simple. When possible, self-administered inhalation analgesia with methoxyflurane would greatly help to alleviate the suffering of the seriously wounded. In Czechoslovakia inhalation of methoxyflurane (AnecotanSPofA) from a simple “Analgizer” (vaporizer) proved to be of greatest help in mine casualties and in traffic accidents, before extrication of the casualties. As long as ether is considered as the “anesthetic for the field” it remains necessary to keep young anesthetists informed and skilled in ether anesthesia.