Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-12T19:36:13.314Z Has data issue: false hasContentIssue false

Chapter 23 - Anesthesia and Pain Management in Field Hospitals

from Section 4 - Clinical Considerations

Published online by Cambridge University Press:  09 January 2020

Elhanan Bar-On
Affiliation:
The Israel Center for Disaster Medicine and Humanitarian Response, Sheba Medical Center, Tel Hashomer, Israel
Kobi Peleg
Affiliation:
National Center for Trauma & Emergency Medicine Research, The Gertner Institute for Health Policy and Epidemiology and Tel-Aviv University, Disaster Medicine Department
Yitshak Kreiss
Affiliation:
Sheba Medical Center, Tel Hashomer, Israel
Get access

Summary

The choice of the anesthetic technique in austere environments is dictated by the availability of medical personnel, electricity, oxygen, and supplies. TIVA appears to be a very promising, reliable alternative for the future of field anesthesia given its safety, simplicity, rapid setup, and small logistical footprint. Therefore, more anesthesia providers need to be trained and educated to be familiar and comfortable with administration of TIVA. Whenever regional nerve block anesthesia use is appropriate, it can be another excellent choice to provide better acute pain control and decrease postoperative complications in austere environments. There is no perfect analgesic, and hence multimodal approach for pain management is imperative. Early pain treatment has been proven to decrease chronicity, improve functionality, and reduce the risk of subsequent development psychological morbidities such as PTSD and depression. The chapter lists the recommendations on prevention and management of the consequences of sexual violence, reduction of HIV transmission, prevention of excess maternal and neonatal mortality and morbidity, and planning of comprehensive reproductive health services in the early days and weeks of an emergency.

Type
Chapter
Information
Field Hospitals
A Comprehensive Guide to Preparation and Operation
, pp. 225 - 230
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Mellor, AJ. Anaesthesia in austere environments. Journal of the Royal Army Medical Corps 2005: 151: 272–6.Google Scholar
Dobson, MB. Anaesthesia at the district hospital. Second edn. World Health Organization; 2006.Google Scholar
Grathwohl, KW, Venticinque, SG. Organizational characteristics of the austere intensive care unit: the evolution of military trauma and critical care medicine: applications for civilian medical care systems. Critical Care Medicine 2008: 36 (7 Suppl): S275–83.Google Scholar
Bartels, SA, VanRooyen, MJ. Medical complications associated with earthquakes. The Lancet 2012: 379: 748–57.Google Scholar
Wilson, J, Barras, P. Advances in anesthesia delivery in the deployed setting. US Army Medical Department Journal Archives 2016: (216): 62–5.Google Scholar
Reynolds, PC, Furukawa, KT. Modern draw-over anesthetic vaporizers used to deliver anesthesia in austere and battlefield conditions. Military Medicine 2003: 168: iiiii.Google Scholar
Szpisjak, DF, Lamb, CL, Klions, KD. Oxygen consumption with mechanical ventilation in a field anesthesia machine. Anesthesia & Analgesia 2005: 100: 1713–17.CrossRefGoogle Scholar
Jiang, J, Xu, H, Liu, H, Yuan, H, Wang, C, Ye, J. Anaesthetic management under field conditions after the 12 May 2008 earthquake in Wenchuan, China. Injury 2010: 41(6): 13.Google Scholar
Barras, P, McMaster, J, Grathwohl, K, Blackbourne, L: Total intravenous anesthesia on the battlefield. US Army Medical Department Journal Archives 2009: 6872.Google Scholar
Mulvey, JM, Qadri, AA, Maqsood, MA. Earthquake injuries and the use of ketamine for surgical procedures: the Kashmir experience. Anaesthesia & Intensive Care 2006: 34: 489–94.Google Scholar
Missair, A, Pretto, E, Visan, A, et al. A matter of life or limb? A review of traumatic injury patterns and anesthesia techniques for disaster relief after major earthquakes. Anesthesia & Analgesia 2013: 117(4): 934–41.CrossRefGoogle ScholarPubMed
Barrington, MJ, Kluger, R. Ultrasound guidance reduces the risk of local anesthetic systemic toxicity following peripheral nerve block. Regional Anesthesia & Pain Medicine 2013: 38: 289–99.CrossRefGoogle Scholar
Jaffer, AK, Campo, RE, Gaski, G, Reyes, M, Gebhard, R et al. An academic center’s delivery of care after the Haitian earthquake. Annals of Internal Medicine 2010: 153(4): 262–5.Google Scholar
Croll, SM, Griffith, SR. Acute and chronic pain on the battlefield: lessons learned from point of injury to the United States. US Army Medical Department Journal Archives 2016: (2 –16): 102–5.Google Scholar
Baker, BC, Buckenmaier, C, Narine, N, et al. Battlefield anesthesia: advances in patient care and pain management. Anesthesiology Clinics 2007: 25: 131–45.CrossRefGoogle ScholarPubMed
Buckenmaier, C, III, Mahoney, PF, Anton, T, Kwon, N, Polomano, RC. Impact of an acute pain service on pain outcomes with combat-injured soldiers at Camp Bastion, Afghanistan. Pain Medicine 2012: 13(7): 919–26.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

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.

Available formats
×

Save book to Google Drive

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.

Available formats
×