Chapter

Anesthetic Considerations in Homeland Disasters

Ernesto A. Pretto Jr.

in Anesthesia Outside of the Operating Room

Published on behalf of Oxford University Press

Published in print March 2011 | ISBN: 9780195396676
Published online August 2013 | e-ISBN: 9780199352814 | DOI: https://dx.doi.org/10.1093/med/9780195396676.003.0029
Anesthetic Considerations in Homeland Disasters

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Based on these assumptions and in keeping with the theme of this book, this chapter will focus primarily on anesthetic considerations in homeland disasters likely to require the presence of the anesthesiologist in the out-of-hospital or pre-hospital environment. Although most anesthesiologists are adept at handling multiple trauma casualties in the familiar setting of the operating room, even during disasters, this fact does not necessarily apply to anesthesiologists’ expertise in the management of casualties of earthquakes or chemical or biological incidents outside the operating room.2 In order to understand the context within which anesthesiologists might be asked to function in the out-of-operating room setting during disaster response, we will devote a part of this monograph to a brief review of the disaster management functions of prehospital emergency medical services (EMS)/trauma systems. We will also describe the reorganization of hospital and intensive care services necessary to handle a surge of incoming critically injured or ill casualties. Our focus will be the role of the anesthesiologist, working in partnership with community or local EMS/trauma system and its network of hospitals, since the local EMS/ambulance system constitutes the functional unit of disaster medical response in the United States. We will end with a brief description of the major challenges we face in the delivery of intensive care services in mass and catastrophic casualty disasters.

Chapter.  10276 words.  Illustrated.

Subjects: Anaesthetics ; Acute Medicine

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