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Continuous Infusion of Ketamine and Althesin for Anesthesia in Disaster Situations

Published online by Cambridge University Press:  17 February 2017

E. Bisio ,
J. Zattoni ,
C.D. Roccatagliata ,
M.R. Germi  and
P. Fuccaro
E. Bisio
Affiliation:
Center of Anesthesiology, University of Ulm, West Germany
J. Zattoni
Affiliation:
Institute of Anesthesiology and Intensive Care Medicine, University of Genoa, Genoa, Italy
C.D. Roccatagliata
Affiliation:
Institute of Anesthesiology and Intensive Care Medicine, University of Genoa, Genoa, Italy
M.R. Germi
Affiliation:
Institute of Anesthesiology and Intensive Care Medicine, University of Genoa, Genoa, Italy
P. Fuccaro
Affiliation:
Institute of Anesthesiology and Intensive Care Medicine, University of Genoa, Genoa, Italy
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Extract

Traffic, industrial or natural disasters and wars frequently threaten the lives of a large number of victims. Often the patients suffer a combination of injuries to the head, extremities, thorax, lung and abdomen. Immediate anesthetic measures at the site of the accident are required and essential to the survival of the patients with multiple injuries. During transport, further surgical and anesthetic treatment may also be needed. Occasionally, the number of people involved in a disaster exceeds the treatment capacity of the nearby medical institutions. Urgent and improvised decisions are required with a clear picture of the treatment resources at the site of the accident or during transport.

Special attention must be focused on necessary surgical measures and intensive care, as well as resuscitation and advanced anesthetic expertise — essential pillars of support. In many cases, the anesthetic treatment of patients with multiple injuries is the decisive therapeutic measure. The anesthetic technique must be guided by the pathophysiological requirements. The medications used should have a controllable and pronounced hypnotic-sedative and analgesic effect, without having a depressant influence on respiration or circulation, and they should improve organ perfusion. Furthermore, they should provide a means for cerebral protection. The anesthetic apparatus should be simple and compact and it should be possible to apply the technique over several hours, using room air, with or without the addition of oxygen. The agents and apparatus should be compatible with the use of every type of muscle relaxant and narcotic. New intravenous anesthetic agents meet these criteria.

Type
Section Three—Definitive Medical Care
Information
Prehospital and Disaster Medicine , Volume 1 , Issue 2 , Summer 1985 , pp. 176 - 179
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

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