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December 4, 1967

Resuscitation and Anesthetic Management of Casualties

Author Affiliations

From C Company, Third Medical Battalion Field Hospital, Da Nang, Vietnam. Dr. Torpey is now with the University of Pittsburgh School of Medicine and the Department of Anesthesiology, Presbyterian University Hospital, Pittsburgh.

JAMA. 1967;202(10):955-959. doi:10.1001/jama.1967.03130230081014

Resuscitative efforts for the severely wounded casualties were directed toward adequate pulmonary ventilation and oxygenation, replacement of blood and extracellular fluid volumes, correction of existing acidosis, and the maintenance of adequate cardiac and renal function. Definitive surgical procedures were performed after adequate resuscitative measures had been accomplished. A light plane of general anesthesia combined with a muscle relaxant was the most satisfactory technique for the extensively injured patient. Spinal, epidural, and axillary blocks were used with relative frequency, especially in those patients having lower abdominal, genitourinary, or extremity injuries. Accurate and frequent monitoring during anesthesia and surgery was performed within the clinical means available. Application of the basic sciences to clinical medicine and the knowledge of reliable publications allowed for the up-to-date management of the battle casualties under field conditions.