901

Index

INDEX

See also Kidneys; Renal dysfunction; Retroperitoneal

injuries

Acute respiratory failure and ventilatory management, 667–705

and ethical dilemmas in use of limited life-sustaining

therapy, 685

mechanical ventilation: initiating, 690–692

mechanical ventilation: physiological effects, 683–684

mechanical ventilation: weaning from, 699–702

mechanical ventilation and combat casualties, 685–689

mechanical ventilatory support: complications, 684–685

monitoring ventilation and oxygenation, 692–698

pulmonary insufficiency: etiology, 669–673

respiratory failure: diagnosis, 680–682

respiratory failure: epidemiology, 669

respiratory failure: etiology, 668

respiratory failure: management, 682–683

respiratory insufficiency: indirect mechanisms, 674–680

ventilators for combat use, 702–704

See also Airway management; Respiratory system

Acute traumatic hemothorax, 465–466

Adult respiratory distress syndrome (ARDS), 668

clinical findings, 679

and corticosteroid treatment, 642

pathophysiology, 679

and respiratory insufficiency, 676–680

and stabilizing the patient, 692

treatment, 678–680

See also Acute respiratory failure and ventilatory management

Advanced Trauma Life Support Course (ATLS), 31–38, 601,

779, 834

and anesthesia providers, 48

battlefield conditions, 33

critique on specific aspects, 33–38

military organization for provision of care, 32–33

See also Combat trauma overview

Adverse reactions

to local anesthetics, 257–259

Aeromedical evacuation

advantages, 756

See also Military medical evacuation

Afrin, 406

AIDS

and microbiologic evaluation, 624–625

and transfusions, 331, 332–333

See also Human immunodeficiency virus (HIV)

Air ambulance, 761

See also Military medical evacuation

Air evacuation, 760–761

See also Military medical evacuation

Airway

classification of, 62

compromised, 533–534

definition, 57

Airway injuries

and face and neck injuries, 441–442

lower-airway injury, 528–529

upper-airway injury, 528

Airway management, 55–76, 446–449

during aeromedical evacuation, 781–782

complications, 66–68

cricothyroidotomy, 68, 69, 449

A

A.H. Robins Co., 222

Abbott, Gilbert, 165

Abbott Laboratories, 215

Abbreviated Injury Scale (AIS), 11, 12–13, 26

Abdominal injuries, 479–494

and damage control, 493–494

and evacuation complications, 776, 777

intraperitoneal injuries, 488–493

and medical outcome, 21–22

perioperative considerations, 483–485

retroperitoneal injuries, 486–488

sites, 485–494

See also Abdominal trauma and war surgery

Abdominal surgery

and applied anatomy for regional anesthesia, 260

and applied physiology for regional anesthesia, 260–261

and epidural anesthesia, 261, 262–263, 264

and intercostal nerve block, 261, 265–267

and interpleural nerve block, 261, 267

and peripheral nerve blocks, 261, 267

and regional anesthesia, 259–267

and spinal anesthesia, 261, 263–265

See also Abdominal trauma and war surgery

Abdominal trauma and war surgery, 480–483

diagnosis, 482

intraoperative blood salvage, 482–483

and recommended modifications of ATLS, 36

and regional anesthesia, 259–267

in World War I, 870

wound ballistics, 481–482

See also Abdominal injuries; Abdominal surgery

Abel, R.M., 727

Acceleration forces

and biophysical effects, 774

Acid-base balance

with hypothermia, 796–797

and transfusion, 329

Acid-base disturbances

in ARF, 728–730

and therapeutic cooling, 820

Acidemia, metabolic, 737–738

Acidosis, metabolic, 729

Acute hypothermia, 792

Acute renal failure (ARF), 709–744

and blood analysis, 718–719

and conservative treatment, 726–731

and diagnostic assessment, 717–719

and dialysis, approaches to, 731–736

and dialytic management, 736–741

in military history, 710–713

and mortality, 711

and pathogenesis, 713–716

pathophysiology of, induced by sepsis, 617

and patient history, 718

and physical examination, 718

and prevention, 719–724

prognosis and outcome, 741–744

protection against incipient failure, 724–726

and radiographic studies, 719

and urinalysis, 718–719
Anesthesia and Perioperative Care of the Combat Casualty

902

direct injury to airway, 74–75

equipment, 59–61, 62–66

with face and neck injuries, 446–449, 451

fundamentals, 57–59

goals, 57–58

and hypothermia, 801, 803

intraoperative, 451

and management of failed intubation, 68–72

mask ventilation, 447

placement of airway devices, 62–66

postoperative, 451

and recommended modifications of ATLS, 35

special considerations, 72–74

with spinal cord injury, 406–407

tracheal intubation, 447–448

tracheostomy, 449

transtracheal jet ventilation, 448–449

See also Acute respiratory failure and ventilatory management; Face and neck injuries; Intubation; Thoracic

injuries

Airway-management adjuncts, 60–61

Airway obstruction, 57, 75

Airway pressures

monitoring, 694–695

Airway resistance

contributory factors, 694

Airway stability

during aeromedical evacuation, 781

Albumin, 555, 880

and nutritional repletion, 584

with sepsis/SIRS, 630–631

See also Blood transfusion; Colloid solutions; Military

transfusion practice; Transfusion therapy

Alcatel Innova A/S, 800

Alcock, Rutherford, 860

Alcohol abuse

See Drug and alcohol abuse

Alfenta, 226

See also Alfentanil

Alfentanil, 226

as adjuvant to inhalational anesthesia, 229

dose regimen, 215

used as total intravenous anesthetic, 230

Alkalosis, metabolic, 729–730

Alkanes, 193

Allen’s test, 107

Allergic reactions

and transfusions, 335

Allergy

to local anesthetics, 312

Alpha-stat pH management, 797

See also Acid-base balance

Alveolar-arterial oxygen

See Gas-exchange indices

Alveolar injury

and pathophysiology, 677–678

Alveolar oxygen

See Gas-exchange indices

Ambulance volante, 753

Ambulances, 760, 761

American Ambulance Hospital (Neuilly, France), 866

American Association of Blood Banking, 333

American Association of Nurse Anesthetists, 873

certification by, 884

American Board of Anesthesiology, 873

American Civil War, 753

American Heart Association

on hypothermia, 801–803

American Journal of Surgery, 866

American Society of Anesthesiologists, 873

American Society of Anesthetists, 873

American Spinal Injury Association (ASIA) motor scores, 410, 411

Ames, A.C., 726

Amidate, 215

See also Etomidate

Amides

selection, 313

Amino acids, 383

and composition for renal failure, 577

and preferential utilization, with stress, 559–561

See also Metabolic derangements and nutritional support;

Metabolites

Aminosteroid pipecuronium bromide, 245

Amnestic agents

See Anxiolytic and amnestic agents

Amputations, 857, 862

and nitrous oxide, 869, 870

Amylene, 861

Anabasis, 788

Anabolic state, 546

See also Metabolic derangements and nutritional support

Analgesia

for burn casualties, 526

early agents, 856–857

produced by anesthetic agents, 223–227

Analgesic drugs

and epidural and intrathecal routes, 315

and intramuscular and intravenous routes, 313–315

mode of administration, 313–316

Analgesics, opioid

and clinical pharmacology, 294–298

Anderson, D.M., 49

Anemia

See Hematological derangements

Anesthesia

of the airway, 62–63

balanced, 535

and children, 862

and computers, 113

discovery, 857–860

evolution, 857–893

maintenance, 462–463, 484–485, 534–536

rapid-sequence induction of, 66

and women, 862

See also Anesthesia for casualties of chemical warfare

agents; Anesthetics; Closed-circuit anesthesia; Combat

anesthesia overview; General anesthesia; Induction of

anesthesia; Inhalational anesthesia; Intravenous

anesthesia; Local and regional anesthesia; Management,

anesthetic; Regional anesthesia

Anesthesia care team, 885

See also Personnel

Anesthesia for casualties of chemical warfare agents, 833–852

aspects of important toxic agents, 837–839

complications of anesthesia by toxic agents, 846–847

injury sites by toxic agents, 840–841

management of anesthesia after toxic injury, 841–846

protection, detection, and decontamination, 839–840

pyridostigmine pretreatment and general anesthesia, 847–

850

See also Anesthesia; Closed-circuit anesthesia; General

anesthesia; Inhalational anesthesia; Intravenous

anesthesia

Anesthesia equipment

in World War I, 867–868

Anesthesia equipment, deployable, 123–126
903

Index

anesthetic drugs, 124, 125

blood-recovery equipment, 124

fluid resuscitation, 126

medical gases, 123–124

miscellaneous equipment, 124–126

physiological monitors, 123

resuscitative equipment, 123

See also Equipment; Military anesthesia machines

Anesthesia machines

clean, 815–816

See also Equipment; Military anesthesia machines

Anesthesia providers in battlefield hospitals, 47–53

education and training before deployment, 47–49

essentials of readiness: equipment, training, and attitude,

51–53

and the future, 52–53

and morale, 52

special problems with blood and blood products, 51

training the team after deployment, 49–51

and worst case scenario, 52

Anesthesiologist

and combat casualty care, 31–38

Advanced Trauma Life Support course, 31–33

aspects of Advanced Trauma Life Support, 33–38

See also Personnel

Anesthetic depth (AD95), 195, 202

Anesthetic management

of extremity casualties, 513–515

of open eye injuries, 429–431

after spinal cord injury, 407

Anesthetic techniques

with burn casualties, 533–536

with intravenous agents, 227–230

Anesthetics

for battlefield anesthesia, 212–214

deployable, 124, 125

local, 254–259

that produce analgesia, 223–227

during Vietnam War, 886–892

during World War I, 868–871

during World War II, 875–878

See also Anesthesia; Potent volatile anesthetics

Anesthetists

See Personnel

“Anoci-association,” 253

Antibiotics

for burn injuries, 525

for casualties with abdominal injuries, 483

during World War II, 881

and wound sepsis, 506

Antimicrobial therapy

for sepsis/SIRS, 637–639

Antipsychotics, 293

Antisepsis, 865

Anuria, 716

Anxiolytic and amnestic agents, 221–223

benzodiazepines, 221–222

droperidol, 223

scopolamine, 222–223

See also individual entries

Aortic rupture, 470

See also Great vessel injuries

Arachidonic acid metabolites

and sepsis/SIRS/MODS, 607–609

ARDS

See Adult respiratory distress syndrome (ARDs)

ARF

See Acute renal failure (ARF)

Arnold, K., 28

Arterial blood gases

monitoring, 110

Arterial cannulation

sites, 107

Arterial oxygen

with sepsis/SIRS, 633

See also Gas-exchange indices

Arterial pressure

See Pulmonary artery pressure

ASIA motor scores

See American Spinal Injury Association (ASIA) motor

scores

Aspiration, 67, 68, 75

and respiratory insufficiency, 674–675

See also Airway management; Pulmonary aspiration

Aspirin

See Nonsteroidal antiinflammatory drugs (NSAIDs)

Assault rifle, 9

Assessment

during evacuation, 779, 782

of nutrition, 565–567

of nutritional repletion, 584–585

preoperative, in chemical warfare casualties, 844–845

and recommended modifications of ATLS, 35

See also Evaluation

Assist-control (AC) ventilation, 687–688

Association for the Advancement of Automotive Medicine, 11

Association of Air Medical Service, 763

ATLS

See Advanced Trauma Life Support Course (ATLS)

Atracurium besylate, 244–245

See also Nondepolarizing muscle relaxants

Atropine, 222, 673

and resuscitation, 879

Attrition in war, 2–6

and battle casualty rates, 6

and historical aspects, 2–3

importance of, due to battle injury, 3–4

and intensity, 5

magnitude of, 4–6

Augmentation teams, 137

Augustine Medical, Inc., 800

Austerity, 33

“Australian antigen,” 332

Autotransfusion, 483

See also Blood salvage, intraoperative; Military transfusion

practice; Transfusion therapy

Auxiliary Surgical Groups, 881

Azotemia, 716–717

See also Acute renal failure (ARF)

B

Bacteremia, 333, 599, 624

See also Bacterial diseases; Sepsis; Systemic inflammatory

response and multiple organ dysfunction syndromes

(SIRS/MODS)

Bacterial diseases, 333

and antimicrobial therapy, 637–638

and evacuation complications, 778

See also Infectious diseases

Bacterial translocation, 648

See also Systemic inflammatory response and multiple

organ dysfunction syndromes (SIRS/MODS)

Baek, S.M., 727

Bair Hugger, 800

Baker Norton Pharmaceuticals, 532
Anesthesia and Perioperative Care of the Combat Casualty

904

Ballistic injuries, 456–457

Baltimore Sun, 754

Baralyme, 159, 161, 162

Barbiturates, 214–215

clinical use and contraindications, 215

early use, 873

pharmacology, 214

physiological effects, 214–215

Barnes, Joseph K., 862

Barometric pressure

and biophysical effects, 771–773

Barotrauma, 671

Barry, K.G., 722

Barton, Edward H., 860

Battle casualty rates, 6

Battlefield anesthesia, 212–214

Battlefield conditions, 33

austerity, 33

casualty density, 33

danger, 33

goals, 33

Battlefield medical environment, 44–46

complexity of medical network, 44–45

nature of evacuation scheme, 45

operations pace, 45

presurgical interventions, 46

technological and logistical support, 44

Battlefield resources and malignant hyperthermia, 814–817

clean anesthesia machine, 815–816

equipment availability, 814–815

laboratory testing, 817

malignant hyperthermia cart, 816–817

Bay Medical, 72

Bayliss, William M., 871

Beall, D., 710

Bear 33, 687, 702, 703

Bear Medical Systems, 702

Beck’s triad, 468

Beebe, G.W., 10

Beecher, Henry K., 876–877, 880, 881

Beecher machine, 876–877, 878, 881, 883

See also Equipment; Military anesthesia machines

Beeson, B.B., 331

Bennett MA-1, 687, 702, 703

Bennett Medical Equipment, 702

Benzid, vapor of, 861

Benzodiazepines, 221–222

and burn casualties, 532

clinical use, 222

pharmacology, 221

physiological effects, 221–222

See also individual entries

Benzylisoquinoline doxacurium chloride, 245

Berman intubating airway, 72

Berry, Frank, 884

Berry Plan, 884

Betadine Solution, 483

Bier blocks, 888

Bier’s method, 275–276

Biological agents, 837

See also Anesthesia for casualties of chemical warfare agents

Biological Warfare Convention, 837

Biophysical properties of inhalational anesthetics, 199–201

Bladder

as injury site, 487–488

See also Retroperitoneal injuries

Blalock, A., 874

Blankets, 798

Blast injuries, 457–458

and pulmonary insufficiency, 670–671

See also Injuries, mechanisms of

“Blast wind,” 7

Bleeding disorders

and uremia, 738–739

See also Hematological derangements

Blister agents

and pulmonary insufficiency, 673

See also Anesthesia for casualties of chemical warfare

agents

Blood, 880, 881

and blood products, 51

planning factors, 343

See also Blood banks; Blood transfusion; Military transfusion practice; Transfusion therapy

Blood agents

and pulmonary insufficiency, 673

See also Anesthesia for casualties of chemical warfare

agents

Blood banks

in DEPMEDS facility, 130

first, 871

preparing, for mass casualties, 364

in Somalia, 365

Blood chemistry abnormalities

and systemic hypothermia, 796–797

See also Blood

Blood-distribution system: interaction guidelines, 369–373

Blood flow changes

and response to stress, 557

See also Metabolic derangements and nutritional support

Blood-gas interpretation

and hypothermia, 803

Blood Gas System, 110

Blood groups, 354–355, 356, 357

Blood inventory tracking operation reports, 350

Blood loss

allowable, 325–326

and closed fractures, 505

See also Blood; Hemorrhage

Blood pressure monitoring, 106–109

central venous and pulmonary artery pressures, 108–109

invasive, 107–108

noninvasive, 106–107

Blood products, 51, 343

developed for future, 358

and interaction guidelines, 369–373

See also Military transfusion practice; Transfusion therapy

Blood Program in World War II, 322

Blood-recovery equipment, 124

Blood Report, sample, 348

Blood salvage, intraoperative

and war surgery, 482–483

Blood-salvage techniques, 88–89

Blood transfusion

during World War I, 871–872

during World War II, 345, 355, 357

See also Military transfusion practice; Transfusion therapy

Blood transfusion at second echelon, 342, 344–351

clinical factors, 347–349

experience from previous wars, 344–346

and field management of transfusion reactions, 349–351

and field use of group O packed red blood cells, 346, 347

technical factors, 346–347

Blood warmers, 799

Blood-warming infusion device, 124

Blumberg, B.S., 332
905

Index

Blunt injuries, 457–458

of head, 376

and pulmonary insufficiency, 669–670

See also Flail chest; Injuries, mechanisms of

Board for the Study of the Severely Wounded in the Mediterranean Theater of Operations, 710–711, 880

Boer War, 865

Bougainville study, 29

Boundary lipids, 192–193

Bowel, small

as injury site, 489–492

See also Intraperitoneal injuries

Bradykinin, 290, 291

Braid, James, 857, 858

Brain injuries

See Face and neck injuries; Neurological injuries

Brain metabolic monitoring, 394

Brain monitoring, 391–392

Brandvold, Benny, 379

Breathing circuit, 158–163

carbon dioxide absorber, 158–160

oxygen flush valve, 158, 160

oxygen monitor, 160–163

Bristol Laboratories, 227

British Journal of Surgery, 379

British Medical Journal, 379

British Shock Committee, 871

Bronchial injuries, 472–473

Brooke Formula, Modified, 524

Brown-Sequard syndrome, 444

Bryan-Brown, C.W., 727

Bunker, J.P., 331

Bupivacaine, 256–257, 313

See also Local anesthetics

Burn injuries, 521–538

chemical and electrical, 529–530

definition, 522

early care for, 523–526

evacuation of casualties, 530–531

fluid administration after resuscitation, 530

inhalation injury, 528–529

pathophysiology, 526–527

perioperative considerations, 531–537

and recommended modifications of ATLS, 37

severity, 523

thermal, 75, 96

See also Injuries, mechanisms of; Thermal injuries

Burrows, L., 334

Burton, J.R., 711

Butorphanol, 227

and clinical pharmacology, 297–298

and side effects, 297

Bywaters, E.G., 710

C

C-5A, 677

C-9 Nightingale, 768, 769

C-130 Hercules, 766, 780

C-141 Starlifter, 767, 780

Cachectin, 607

See also Tumor necrosis factor (TNF)

Caffeine contracture test, 827

Calcium, 512

abnormalities, in ARF, 731

and local anesthetics, 305

See also Excitation-contraction coupling pathway; Hypocalcemia

Caloric requirements

in stressed patients, 561

Calverley, Roderick, 866

Cameron, J.S., 744

Camino Laboratories, 393

Candida

See also Fungal infection

Cannabis, 863

Cannon, Walter B., 871, 872

Cannulation

arterial, sites of, 107

Capnography, 110–111, 695–696

Carafate, 650

Carbohydrates

See Metabolites

Carbon dioxide-absorbent granules, 158–159, 161, 162, 163

Carbon dioxide absorber, 158–160

Carbon dioxide-response curve

and potent inhaled agents, 203, 204

Carbon monoxide intoxication

and inhalation injury, 528

Carded for record only, 13, 14

Cardiac contusions, 468–469

Cardiac index, 611

with sepsis/SIRS, 633

Cardiac rupture, 469

Cardiac tamponade, 466–468

Cardiopulmonary resuscitation

and systemic hypothermia, 801–803

Cardiovascular disease

and evacuation complications, 777

Cardiovascular system

and barbiturates, 214

and benzodiazepines, 221–222

and blood pressure, 106–109

and droperidol, 223

and electrical injury, 529

and electrocardiography, 109

and established multiple organ failure, 649–650

and etomidate, 216

and evacuation complications, 777

and hemorrhage, 82–83

and hypothermia, 792–794, 795–796

and ketamine, 218–219

and local anesthetic toxicity, 310–312

management of, after spinal cord injury, 411

and mechanical ventilation effects, 683–684

and monitoring, 106–109

and morphine, 295–296

and oculocardiac reflex, 432–433

and opioid agonist drugs, 224

and potent inhaled agents, 204–205

and regional anesthesia, 260

and response to sepsis/SIRS, 611–614

and scopolamine, 222–223

and secondary pain manifestations, 293

and spinal cord injury, 400–403

and thiopental, 66

and transesophageal echocardiography, 109

and uremic pericarditis, 738

See also Chest injuries; Thoracic injuries

Casualty

definition, 2

Casualty care decision tree, 34

Casualty density, 33

Catabolic index, 566

Catabolic state, 546

See also Metabolic derangements and nutritional support
Anesthesia and Perioperative Care of the Combat Casualty

906

Choking agents

and pulmonary insufficiency, 673

See also Anesthesia for casualties of chemical warfare agents

Chromium, 572

Chromosome 19-linked defect

and malignant hyperthermia, 825

See also Genetic factors

Chronic hypothermia, 792

See also Hypothermia; Systemic hypothermia

Churchill, Edward D., 322

CIBA Corning Diagnostics, 110

Circulatory system

management of, after head injury, 396

and regional anesthesia, 260–261

in spinal cord, 403

Circulatory system, cerebral

and head injury, 385–386

and intensive care unit management, 391

Civilian experience

and ARF, 713

and evacuation priorities, 761–763, 766

and helicopter checklist, 764

and medical problems during evacuation, 777

and sepsis/SIRS/MODS, 599–600

and Trauma Score, 761, 762–763

and triage decision scheme, 765

Civilian practice, good

principles of, 336

Claymore mine, 9

Clean anesthesia machine, 815–816

Clemmer, T.P., 763

Clinical syndrome of malignant hyperthermia

See Malignant hyperthermia, clinical syndrome

Clinical use

of barbiturates, 215

of droperidol, 223

of etomidate, 216

of ketamine, 219–221

of local anesthetics, 256, 258

of propofol, 217

of scopolamine, 223

Closed brain injury, 382

See also Neurological injuries

Closed-circuit anesthesia, 104–105, 175–185

and oxygen and positive-pressure ventilation, 177–179

and potent volatile anesthetics, 179–184

during World War II, 878, 881

See also Anesthesia; Anesthetics; General anesthesia;

Inhalational anesthesia

Closed head injury, 376, 378, 386

See also Neurological injuries

Clostridium difficile

and pseudomembranous colitis, 583

and sepsis/SIRS/MODS, 604

See also Bacterial diseases; Systemic inflammatory

response and multiple organ dysfunction syndromes

(SIRS/MODS)

Clover, Joseph T., 863, 864, 866

Coagulation

disseminated intravascular, 328, 623

and established multiple organ failure, 651

monitoring, 105–106

See also Hematological derangements; Hemodynamic

derangements; Hemorrhage; Hemostasis and coagulation

Cocaine, 257, 302, 312–313, 861, 863, 878

See also Local anesthetics

Coexisting disease

with abdominal injuries, 484

Catheters

endotracheal, 873

and evacuation, 780

Celiotomy, staged, 493

Cell Saver 4, 88

Cellular injury

and ARF, 715–716

Cellular and subcellular components and mechanisms and

SIRS/MODS, 603–604, 605–607

Central nervous system

and barbiturates, 214

and benzodiazepines, 221

and droperidol, 223

and etomidate, 215

and hypothermia, 792

and ketamine, 218

and local anesthetic toxicity, 310

monitoring, 111–112

and opioid agonist drugs, 224

and potent inhaled agents, 203–204

and scopolamine, 222

and toxic injury, 841

See also Neurological injuries

Central venous pressure, 108–109

Cerebral blood flow monitoring, 393

Cerebral wounds

and nitrous oxide, 869

See also Face and neck injuries; Neurological injuries

Cervical spine injuries, 443–445

and airway-management issues, 73–74

blunt, management of, 444–445

evaluation of, 444

and spinal cord injuries, 443–444

and vertebral injuries, 443

See also Face and neck injuries; Neurological injuries;

Thoracic injuries

Champion, H., 743

Chan, V., 743

Chemical agent monitors (CAMs), 839–840

Chemical and biological protective shelter (CBPS), 135–137

Chemical and electrical burns, 529–530

See also Anesthesia for casualties of chemical warfare agents

Chemical warfare

and pulmonary insufficiency, 672–673

See also Anesthesia for casualties of chemical warfare agents

Chemically contaminated casualties

and resuscitating combat casualties, 97

See also Anesthesia for casualties of chemical warfare agents

Chemiosmotic theory, 544

Chest injuries

and evacuation complications, 776

and medical outcome, 20–21

See also Thoracic injuries

Chest radiography, 698

in sepsis/SIRS, 627

Chest surgery

in World War I, 870

See also Thoracic injuries

Children

and anesthesia, 862

Chisolm, J.J., 862–863

Chloroform, 860–861

apparatus, 864, 867

discredited, 878

and ether, 867; and shock, 869

See also Anesthesia; Anesthetics

Chloroprocaine, 257

See also Local anesthetics
907

Index

Cold War, 884

Colloid solutions, 91, 630–631

for burn casualties, 530

and head injury casualties, 389

for resuscitation, 91

Colon

as injury site, 489–492

See also Abdominal injuries; Intraperitoneal injuries

Colton, Gardner Q., 863

Combat anesthesia overview, 43–53

and battlefield medical environment, 44–46

and expanded role of practitioners, 31, 47–53

See also Anesthesia; Combat trauma overview

Combat injury

and medical outcome, 13–31

nature of, 6–13

See also Nature of combat injury

Combat trauma overview, 1–39

anesthesiologist and combat casualty care, 31–38

attrition in war, 2–6

medical outcome of combat injury, 13–31

nature of combat injury, 6–13

Communications zones

corps and, 763–768

Comorbidity

See Coexisting disease

Compartment syndrome

and extremity injuries, 507–508

Complement cascade, 677

and sepsis/SIRS/MODS, 610, 610–611

Component therapy

vs whole blood, 324–325

Computer models

and attrition, 4

Computerized tomography

in sepsis/SIRS, 628

Computers in anesthesia, 113

Concentration and dosage

of potent volatile anesthetics, 181–182

Concentration effect, 198, 201

Condon, Brian F., 886, 893

Condor Squadrons, 754

Conduction, 790

Conger, J.D., 711, 743

Contamination, chemical, 97

See also Anesthesia for casualties of chemical warfare agents

Continuous arteriovenous hemodiafiltration (CAVH-D), 735–736

Continuous arteriovenous hemofiltration (CAVH), 735

Contract nurses, 865

Contraindications

for barbiturates, 215

for droperidol, 223

for etomidate, 216

for ketamine, 219

for propofol, 217

for scopolamine, 223

Controlled mechanical ventilation (CMV), 687

Convection, 790

Copper, 572

Core temperature, 789

Corneal abrasion, 432

Coronary artery injuries, 469–470

Corps and communications zones, 763–768

Corpsmen

See Personnel

Corticosteroids

for sepsis/SIRS/MODS, 642–643

Cotton and Boothby, 869

Courington, Frederick, 866

CRAMS (circulation, respiration, abdomen, motor, speech)

scale, 763

Creatinine-Height Index, 585

Cricothyroidotomy, 68, 69, 449

Crile, George W., 253, 866–867, 868, 870, 872

Crimean War, 753, 861

Critical temperature, 149

Crystalloid solutions, 630

for resuscitation, 89–91

“Culture-negative sepsis,” 647

Curare, 879

See also Recurarization

Curling, T.B., 526

Curling’s ulcers, 526, 532

Cushing, Harvey, 379, 380, 384

Cushing phenomenon, 384

Cutaneous side effects

of morphine, 296

See also Dermatological manifestations; Skin

Cutoff effect

in general anesthetics, 189–190, 192

Cutting, R.T., 28

Cyanide, 673

See also Blood agents

Cyclooxygenase inhibitors

for sepsis/SIRS/MODS, 643

Cyclopropane, 873

Cytokines

and sepsis/SIRS/MODS, 607

Cytomegalovirus (CMV)

and transfusion, 333

D

Damage control

in casualties with severe injuries, 493–494

Daniels, John Chase, 886

Dantrolene therapy

for hyperthermia, 819

Data collection

on burn injuries, 523–524

See also Computers in anesthesia

Davis, R.F., 723

Davy, Humphry, 857, 858

De Mooy, Surgeon General (Dutch), 754

Dead space, 696

Death

early, 16, 601

immediate, 16, 601

late, 16, 601

See also Mortality

DeBakey, M.E., 10

Debridement, 506

Decontamination

selective, of gut, in sepsis/SIRS, 640–641

and toxic agents, 839–840

Decubitus ulcers

after spinal cord injury, 413

“Deep sulcus sign,” 627, 698

Deep venous thrombosis and pulmonary embolism, 508–510

diagnosis, 509

prophylaxis, 510

treatment, 509–510

Defense Medical Standardization Board, 122

Deferoxamine, 529

Defibrillator

See Equipment; Monitors
Anesthesia and Perioperative Care of the Combat Casualty

908

Degenerate theory, 193

Dehydration

and resuscitation, 95

Delayed primary closure, 506

Demerol, 225

See also Meperidine

Dentists

in anesthetic service, 867

See also Personnel

Dependence

on morphine, 296

Deployable hospitals, 115–139

deployable anesthesia equipment, 123–126

DEPMEDS-equipped hospitals, 126–131

history of deployable medical systems, 119–123

and Medical Force 2000, 134–138

in the Persian Gulf War, 132–134

Deployable medical systems, 119–123

and ARF, 713

DEPMEDS (Deployable Medical Systems), 119, 713

DEPMEDS-equipped hospitals, 126–131

ancillary support areas, 130–131

patient care areas, 127–130

DEPMEDS Policies/Guidelines Treatment Briefs, 122–123

Depolarization block, 236

and pyridostigmine, 849

See also Succinylcholine chloride

Depolarizing muscle relaxant

See also Succinylcholine chloride

Dermatological manifestations

and morphine, 296

of sepsis/SIRS, 623

and toxic injury, 840

See also Cutaneous side effects; Skin

Desflurane, 194, 195, 197–198

See also Anesthetics; Inhalational anesthesia; Military

anesthesia machines

Detection

of toxic agents, 839–840

Dextran, 91

See also Resuscitation fluid selection

Dezocine

and clinical pharmacology, 298

Diagnosis

in abdominal trauma and war surgery, 482

of ARF, 716, 717–719

of fat embolism syndrome, 511, 512

of malignant hyperthermia, 819

of neurological manifestations from sepsis/SIRS, 618–619

of oliguria, acute, 716

of pulmonary embolism, 509

of respiratory failure, 680–682

of sepsis/SIRS, 623–629

of thoracic injuries, 459, 464–475

Diagnosis and monitoring of patients with sepsis/SIRS, 623–629

bedside monitors, 625–627

hematological evaluation, 624

microbiologic evaluation, 624–625

radiological procedures, 627–628

surgical reexploration, 628–629

Diagnostic peritoneal lavage (DPL), 482

Dialysis

approaches, 731–736

and ARF, 731–736, 736–741

and circulatory access, 732

and complications, 739–740

conventional hemodialysis, 731–734

equipment and support, 734

frequency, 741

goals, 736

and hemofiltration, 735–736

and hypercatabolism, 739

and hyperkalemia, 730, 738

indications, 736–739

management, 736–741

and metabolic acidemia, 737–738

peritoneal dialysis, 734–735

and practical aspects, 740–741

and sorbent-based delivery system, 732–734

timing, 741

and uremia, 738–739

and volume overload, 737

See also Acute renal failure (ARF)

Diaphragm

as injury site, 493

traumatic rupture, 473–475

See also Intraperitoneal injuries

Diarrhea, 583–584

Diazepam, 221

See also Benzodiazepines

Died of wounds, 14–16, 28, 601

See also Mortality

Diet

See Nutritional support

Diffuse brain injury, 382

Diprivan, 216

See also Propofol

Disease transmission

and transfusions, 331–334

Dissociative anesthesia, 217

Distribution

of local anesthetics, 309

Diuretics

in ARF therapy, 728

for burn casualties, 530

loop and osmotic, 722

Divinyl oxide, 873

Domestic aeromedical evacuation system, 768–771

and U.S. Air Force patient classification, 770

Don B. Hickon, Inc., 37

Dopamine, 722, 723

Dosage

definition, in potent volatile anesthetics, 179

See also Concentration and dosage

Double-burst stimulation, 239

DRASH (deployable rapid assembly shelter) tents, 136

Dripps, Robert D., 883

Droperidol, 223

and clinical pharmacology, 298

clinical use and contraindications, 223

physiological effects, 223

Drug and alcohol abuse

and medically safe evacuation, 779

Drug effects

on intraocular pressure, 429

Drug interactions

and complications of neuromuscular blockade, 246

and eye injuries, 431

between pyridostigmine and general anesthetics, 848

Drugs

interventions to prevent ARF, 721–724

See also Anesthesia; Anesthetics; Drug and alcohol abuse;

Drug interactions; Medications; Pharmacology

Du Pont Multi-Source Products, 227

Dunant, Henri, 288

Duodenum
909

Index

as injury site, 488

See also Retroperitoneal injuries

Dupaco Hemokinititherm Fluid Warmer, 799

Dyscrasia, platelet

and sepsis/SIRS, 622–623

E

Echelons of care

and airway management, 58, 68

and blood transfusion practices, 342–344, 344–351, 351–

354, 362–363

and laboratory procedures, 131

and monitors, 102–105

and trauma management function, 32

Echocardiography

in sepsis/SIRS, 626–627

transesophageal, 109

Education of personnel

on blood and blood products, 51

before and after deployment, 47–49, 49–51

for dialysis technicians, 734

during Korean War, 882–883, 884

in Persian Gulf War, 361

and readiness, 51–53

in use of military anesthesia machines, 143, 170–171

during Vietnam War, 885

during World War I, 867, 871, 872

during World War II, 874, 881

between World Wars, 873

Edwards/Baxter, 573

Eicosanoids

and sepsis/SIRS/MODS, 607–609

Electrical burns

See Chemical and electrical burns

Electrocardiography, 109

Electroencephalographic monitoring, 393

See also Monitoring; Monitors

Electrolytes

and head trauma, 397–398

and hypothermia, 796

and managing imbalance in ARF, 730–731

after spinal cord injury, 413

Elimination

of local anesthetics, 309

Embolic phenomena

See Thrombolic and embolic phenomena

Emergence

with burn casualties, 537

with open eye injuries, 431

Emergence reaction, 218, 219, 220

Emergency War Surgery NATO Handbook, 35, 523, 525

Emotional support

after spinal cord injury, 413

Emphysema

See Adult respiratory distress syndrome (ARDS)

En seton gunshot wound, 503

Encephalography, 112

Endocrine system

and regional anesthesia, 261

and responses to trauma, 294

and secondary pain manifestations, 294

Endocrinological responses

to sepsis/SIRS, 619

Endogenous mediators

and sepsis/SIRS/MODS, 607–611

“Endogenous pyrogen,” 555

Endorphins

and sepsis/SIRS/MODS, 609

Endotoxins, 604, 605

See also Systemic inflammatory response and multiple

organ dysfunction syndromes (SIRS/MODS)

Endotracheal, catheter, 873

Endotracheal intubation

and managing respiratory failure, 682–683

See also Intubation

Eneas, F., 721

Energy requirements

and injuries and infection, 561–564

and stores, 546

See also Metabolic derangements and nutritional support

Energy transfer, 9

Enflurane, 194, 195, 196

See also Anesthetics; Inhalational anesthesia; Military

anesthesia machines

Enteral nutrition, 527, 579–584

and delivery, 582–583

and diarrhea, 583–584

and feeding tolerance, 583

and feeding tube access, 582–583

and feeding tube maintenance, 584

formulations, 580–582

monitoring, 583

oral supplements, 580–581

and surgical access, 582

See also Gastrointestinal precautions; Gastrointestinal

system; Metabolic derangements and nutritional support

Enterobacter species, 603

See also Bacterial diseases; Systemic inflammatory

response and multiple organ dysfunction syndromes

(SIRS/MODS)

Eosinophils

and sepsis/SIRS, 621

Epidemiology

aspects of, in pain study, 289

of respiratory failure, 669

See also Epidemiology of sepsis/SIRS/MODS

Epidemiology of sepsis/SIRS/MODS, 598–611

cellular components contributing to sepsis/SIRS/MODS,

605–607

cellular and subcellular mechanisms leading to sepsis/

SIRS/MODS, 603–604

civilian experience, 599–600

endogenous mediators, 607–611

microorganism components and products that give rise to

sepsis/SIRS/MODS, 604–605

military experience, 600–601

trauma-related sepsis and septic shock, 601–603

traumatic injury, 601

Epidural route

and analgesic drugs, 315

Epinephrine

with local anesthetics, 309

Epstein-Barr virus

and transfusion, 333

Equipment

for airway management, 59–61

and chloroform, 864

DEPMEDS, 122

for dialysis, 734

for emergency airway management, 406

during Korean War, 883–884

for physiological monitoring, 103

for potent volatile anesthetics, 182–183

and readiness, 51–53

required for evacuation, 779

resuscitation, 123
Anesthesia and Perioperative Care of the Combat Casualty

910

surgical, 117

for treatment of malignant hyperthermia, 814–815

during Vietnam War, 886–892

during World War I, 867–871

during World War II, 117, 875–878

See also Military anesthesia machines; Monitors; Physiological monitoring; Ventilators for combat use

Erythrocytes

and sepsis/SIRS, 621–622

Erythroxylon coca, 302

Escherichia coli, 603, 622

See also Bacterial diseases; Systemic inflammatory

response and multiple organ dysfunction syndromes

(SIRS/MODS)

Esophageal injuries

with face and neck injuries, 442–443

Esters

selection, 312–313

Ethers, 193

and ethylene, 873

open-drop, 878

and shock, 872

sulfuric, 860

during World War II, 877

See also Anesthesia

Ethical dilemmas in limited life-sustaining therapy, 685

Ethyl chloride, 863, 870, 878

Ethylene, 861

and ether, 873

Etidocaine, 257, 313

See also Local anesthetics

Etiology

of established multiple organ failure, 647–648

of pulmonary insufficiency, 669–673

of respiratory failure, 668

Etomidate, 215–216

and airway management, 73

with burn casualties, 534

clinical use and contraindications, 216

dose regimen, 215, 228

pharmacology, 215

physiological effects, 215–216

used as total intravenous anesthetic, 230

Evacuation

of burn casualties, 530–531

checklist, 531

nature of scheme, 45

and neurological injuries, 778

and recommended modifications of ATLS, 37–38

during Vietnam War, 885–886

during World War II, 879

See also Military medical evacuation; Transport

Evaluation

and airway management, 58–59

of cervical spine injuries, 444

and spinal cord injury, 404

of susceptibility to malignant hyperthermia, 826–827

See also Assessment

Evaporation, 790

Evita, 687

Evoked potentials

and cerebral monitors, 392–393

sensory, 112

somatosensory, 408

Excitation-contraction coupling pathway

in malignant hyperthermia, 823–825

Exercise

and metabolism, 549–551

and starvation and stress, 551–553

See also Metabolic derangements and nutritional support

Exhaled volume monitoring, 696

Experimental drugs

to prevent ARF, 722, 723–724

Extracellular fluids

and hemorrhage, 84

reduced, and ARF, 714

and volume replacement, 335–336

Extremity injuries, 499–515

and anesthetic management, 513–515

complications, 507–513

injury patterns, 500

intraoperative monitoring, 515

and medical outcome, 22

nature of, in combat casualties, 501–507

and recommended modifications of ATLS, 37

and regional anesthesia, 513–514

Eye injuries, 425–433

and airway-management issues, 74

anesthetic management of open eye injuries, 429–431

drug effects on intraocular pressure, 429

drug interactions, 431

and evacuation complications, 778

eye anatomy and physiology, 426–428

perioperative ophthalmic complications, 432–433

and toxic injury, 841

See also Face and neck injuries, ocular injuries; Ocular

injuries

F

Face masks, 60, 873

Face and neck injuries, 437–452

airway management, 446–449

cervical spine injuries, 443–445

facial fractures, 440–441

neck injuries, 441–443

neurological injuries, 445–446

ocular injuries, 446

perioperative anesthetic management, 449–451

See also Airway management; Neurological injuries

Facial fractures, 440–441

mandibular fractures, 440

maxillary fractures, 440–441

nasal fractures, 440

zygomatic fractures, 441

See also Face and neck injuries

Fading, Howard D., 882

Falklands War

and evacuation air base, 755–756

and ketamine, 219

Faraday, Michael, 857

Fat embolism syndrome, 510–513

diagnosis, 511, 512

laboratory changes, 512

pathophysiology, 510–512

prognosis, 513

treatment, 512

“Fatigue poisons,” 554

Fatigue and sleep lag

and biophysical effects, 775

Fats

See Lipids; Metabolic derangements and nutritional

support; Metabolites

Febrile reactions

and transfusions, 335

Feeding tolerance, 583
911

Index

Feeding tube

and access, 582–583

and diarrhea, 583

and maintenance, 584

and placement, 583

Fentanyl, 224, 225–226

as adjuvant to inhalational anesthesia, 229

and clinical pharmacology, 296–297

with droperidol, 223

and side effects, 297

Fenton reaction, 715–716

Ferguson, J., 188–189

Ferguson’s rule, 189

Fiberoptic laryngoscope, 68, 72

Fibronectin

and nutritional repletion, 585

and sepsis/SIRS, 610

Field anesthesia, 205–206

Field anesthesia chest, 892

Field Anesthesia Machine (FAM) Model 785, 142

See also Equipment; Military anesthesia machines

Field Anesthesia Machine (FAM) Model 885A, 142, 143–165, 176

attaching medical gas supply, 149–151

breathing circuit, 158–163

checkout and maintenance, 163–165

flowmeters, 154–155

and future recommendations, 170–171

lower case, 143–148

pipeline circuits, 151–154

upper case, 148, 149

vaporizer, 155–158

See also Equipment; Military anesthesia machines

Finn, W.F., 713

Flail chest, 464–465, 669–670

See also Blunt injury

Fluid administration for burn casualties, 530

colloids, 530

diuretics, 530

hypertonic saline, 530

Fluid compartment shifts

and hemorrhage, 83–84

Fluid imbalance

and head trauma, 397–398

Fluid management, intraoperative

with burn casualties, 536

See also Hypovolemia; Military transfusion practice;

Transfusion therapy

Fluid resuscitation

of burn casualties, 524

in deployable facilities, 126

for sepsis/SIRS, 629–631

See also Hemorrhage, shock, and fluid resuscitation

Fluid therapy

for ARF, 728

Fluid warmers, 799

Fluroxene, 194

Focal brain injury, 382

Foregger machine, 883

See also Equipment; Military anesthesia machines

Forward Surgical Team (FST), 135–137

Fracture stabilization

during aeromedical evacuation, 782

Franco-Prussian War

and evacuation, 754

Free radicals

and inhalation injuries, 529

oxygen, 383, 554

and sepsis/SIRS/MODS, 609–610

Free radical scavengers

and ARF protection, 723

and spinal cord protection, 410

Freeman, N.E., 874

Frequency-dependent blockade

and local anesthetics, 305–306

“Friendly fire,” 2

Fry, D.E., 644, 647

Fulminant malignant hyperthermia, 812–813, 817–819

Fungal infection

and therapeutic modalities, 639

See also Systemic inflammatory response and multiple

organ dysfunction syndromes (SIRS/MODS)

Furosemide, 722

G

Gallego, A., 743

Gangrene, gaseous

and nitrous oxide, 869

See also Anesthesia for casualties of chemical warfare

agents

Garcia-Martin, F.A., 743

Garrison, R.N., 647

Gas anesthesia, 874

See also Medical gas

Gas exchange, abnormal

and pathophysiology, 678

Gas-exchange indices

monitoring, 693–694

Gas warfare casualties

and anesthesia, 870

See also Anesthesia for casualties of chemical warfare

agents

Gaseous gangrene

and nitrous oxide, 869

See also Anesthesia for casualties of chemical warfare

agents

Gases, dissolved

and acid-base balance, with hypothermia, 796–797

Gastrointestinal precautions

with burn casualties, 525–526

Gastrointestinal reconstruction, delayed, 493

Gastrointestinal system

and complications after spinal cord injury, 412

and established multiple organ failure, 650–651

and head trauma, 397–398

and hypothermia, 796

and morphine, 296

and NSAIDs, 301

and regional anesthesia, 261

and secondary pain manifestations, 293–294

General anesthesia

characteristics of true agent, 188

and extremity injuries, 514–515

for face and neck injuries, 450–451

and pyridostigmine pretreatment, 847–850

vs regional anesthesia, 253

See also Anesthesia; Anesthesia for casualties of chemical

warfare agents; Anesthetics; Closed-circuit anesthesia;

Inhalational anesthesia; Intravenous anesthesia

General anesthetics

and cutoff effect, 189–190

and lack of structural specificity, 188–189

and pressure reversal, 190

and stereoselectivity, 190

Genetic factors

and malignant hyperthermia, 822, 825, 826
Anesthesia and Perioperative Care of the Combat Casualty

912

Genitourinary system

and complications after spinal cord injury, 413

See also Urinary system

George Washington University Hospital, Critical Care

Medicine group, 644, 647

Gillum, D.M., 743

Glasgow Coma Scale, 73, 445, 763

Glasgow coma score (GCS), 387–389

Glasgow outcome scale (GOS), 387–389

Glaucoma, acute angle-closure, 432

Glomerular filtration, decreased

and ARF, 714–715

Glottic injuries

See Airway management

Glucagon, 546, 548

Glucocorticoids

and spinal cord protection, 409–410

Glucose, 546

phases of homeostasis, 550

serum, and hypothermia, 796

Glycine

working as neurotransmitter, 190

Glycogen, 548

Glycopyrrolate, 222, 532

GM1 ganglioside

and spinal cord protection, 410

“Golden hour”

absence of, in combat trauma, 16–17

in evacuation, 756, 779

Gormican, S.P., 763

Grande, C.M., 31

Grantham, J.J., 743

Gravitational forces

and biophysical effects, 774

Great vessel injuries, 470–471

Great War

See World War I

Ground evacuation, 759–760

See also Military medical evacuation

Guedel, Arthur, 867

Gum acacia, 871

Gut decontamination, selective

in sepsis/SIRS, 640–641

Gwathmey, James Tayloe, 866, 868, 869, 870

H

Haber-Weiss reaction, 715–716

Haemonetics Corp., 124

Haiti

evacuation scheme, 45

Halothane, 157, 194–195, 886

See also Anesthetics; Inhalational anesthesia; Military

anesthesia machines

Halothane contracture test, 827

Halsted, William Stewart, 863, 868

Hamman’s sign, 472

Hampton’s hump, 698

Hannibal, 4, 752, 788

Hartmann’s pouch, 492

Head injuries

and airway-management issues, 72–73

in combat, 376–378

and hemorrhagic shock, 96–97

and medical outcome, 18–20

and resuscitating combat casualties, 96–97

See also Face and neck injuries; Neurological injuries

Head trauma

and medical complications, 397–398

and recommended modifications of ATLS, 36–37

See also Face and neck injuries; Neurological injuries

Health Service Support Tenets, 119

Heat conservation

in normal thermoregulation, 790, 791

Heat gain

estimated sources, 799

Heat loss

in normal thermoregulation, 790, 791

See also Hypothermia; Systemic hypothermia; Temperature

regulation

Heat production

in normal thermoregulation, 789–790, 791

Heaton, Leonard D., 322

Heatpac Personal Heater, 800

Heidbrink military model 685, 876, 878

See also Equipment; Military anesthesia machines

Heisenberg’s principle, 182

Helicopter evacuation, 758–759, 760–761

and civilian checklist, 764

See also Military medical evacuation

Hematocrit

in burn casualties, 536

and transfusion therapy, 326

See also Hematological derangements

Hematological and coagulation defects

and sepsis/SIRS, 620–623

See also Hemostasis and coagulation

Hematological derangements

and burn injuries, 527

and evacuation complications, 778

in fat embolism syndrome, 512

and nuclear warfare, 673

See also Hemostasis and coagulation

Hematological effects

of hypothermia, 796

of NSAIDs, 301

See also Hematological derangements

Hematological evaluation

and evacuation complications, 778

of sepsis/SIRS, 624

Hemochron system, 106

Hemodialysis, conventional, 731–734

See also Dialysis

Hemodynamic derangements

and burn injuries, 527

See also Hemostasis and coagulation

Hemodynamic monitoring, 698

Hemofiltration, 735–736

continuous arteriovenous hemodiafiltration (CAVH-D),

735–736

continuous arteriovenous hemofiltration (CAVH), 735

slow, continuous ultrafiltration (SCUF), 735, 736

Hemoglobin

and evacuation complications, 778

with sepsis/SIRS, 633

and transfusion therapy, 326

Hemolytic transfusion reactions, 334–335

Hemopheresis, 359

Hemopneumothorax, 669

See also Acute respiratory failure and ventilatory management

Hemorrhage, 82–85

and cardiovascular response, 82–83

estimation of, 85
913

Index

and extracellular fluid loss, 84

and fluid compartment shifts, 83–84

and oxygen transport, 84–85

See also Blood loss; Hematological derangements; Hemodynamic derangements; Hemostasis and coagulation

Hemorrhage, shock, and fluid resuscitation, 81–97

hypovolemia, 85–89

physiological consequences of hemorrhage, 82–85

related conditions in combat casualties, 95–97

resuscitation fluid selection, 89–92

supplemental therapeutic measures, 92–95

Hemorrhagic shock

and compensatory response, 83

and head injury, 96–97

and resuscitating combat casualties, 96–97

and scopolamine, 223

Hemostasis and coagulation

and head injury, 385

monitoring, 105–106

restoration of, 326–329

and sepsis/SIRS, 620–623

surgical, 329

and uremic bleeding disorders, 738–739

See also Cardiovascular system; Hematological derangements; Hemodynamic derangements; Hemorrhage;

Military transfusion practice; Transfusion therapy

HemoTec, Inc., 105–106

Hemothorax, 669

acute traumatic, 465–466

See also Acute respiratory failure and ventilatory management

Heparin, 105–106, 509

Hepatic failure

and modifications of parenteral nutrition, 577–578

Hepatic injury

severity classification, 486

See also Hepatic failure; Hepatitis; Retroperitoneal injuries

Hepatic system

and established multiple organ failure, 650–651

and potent inhaled agents, 205

Hepatitis

and transfusion, 331–332

Hepcon, 105–106

Hespan, 91

See also Resuscitation fluid selection

Hetastarch

and sepsis/SIRS, 631

See also Colloid solutions

Hewitt, Frederick, 866

Hexoses, 545

Hickman, Henry Hill, 857

High-frequency ventilation, 689

Hill-ROM, 413

Hinckley, Robert, 859

Historical trends in combat mortality, 17–18

History of military anesthesia, 855–893

during American Civil War, 862–863

discovery, 857–860

early analgesics, 856–857

during Korean War, 882–884

and late 19th-century advancements, 863–865

during Mexican War, 860–862

in post-Vietnam War era, 892–893

during Spanish-American War, 865–866

during Vietnam War, 885–892

during World War I, 866–872

during World War II, 874–882

between World Wars, 873–874

See also individual war entries; Combat anesthesia

overview; Military medical evacuation, history

HMMWVs (high-mobility, multipurpose, wheeled vehicles),

M996 and M997, 135, 136, 760

Hormones

and stress, 554

See also Metabolic derangements and nutritional support;

Stress response

Hospital ships, 137–138

Hospitals: combat support, field, and general, 137

See also Deployable hospitals

Hou, S.H., 719

Human immunodeficiency virus (HIV)

and transfusion, 331, 332–333

See also AIDS

Humid-Vent Heat-Moisture Exchanger, 781

Humidifiers

and aeromedical evacuation, 781

Humphreys, M.H., 721

Hydrostatic pulmonary edema

and respiratory insufficiency, 675–676

See also Acute respiratory failure and ventilatory management

Hypercatabolism, 739

Hyperkalemia, 730, 738

and therapeutic cooling, 820

and transfusion, 330–331

Hypermetabolism, 555

and meaning, 615

and transition to MODS, 564

See also Metabolic derangements and nutritional support;

Sepsis; Systemic inflammatory response and multiple

organ dysfunction syndromes (SIRS/MODS)

Hyperreflexia, autonomic, 444

and spinal cord injury, 401–403

Hyperthermia

and resuscitating combat casualties, 95

See also Malignant hyperthermia

Hypertonic solutions

for burn casualties, 530

for resuscitation, 91–92

Hypocalcemia

and ARF, 731

and transfusion, 330–331

See also Calcium

Hypodermic syringe, 863, 865

Hypotension

and sodium thiopental, 66

Hypothermia, 95–96

and acid-base balance, 796–797

and resuscitating combat casualties, 95–96

therapeutic, 94

topical, and spinal cord protection, 409

and transfusion, 330

See also Systemic hypothermia; Temperature regulation

Hypovolemia, 85–89

blood-salvage techniques, 88–89

intraosseous fluid infusion, 89

intravenous fluid-delivery systems, 87–88

and management, 879–880

venous access, 87

See also Blood transfusions; Military transfusion practice;

Transfusion therapy

Hypoxemia, 60

and diagnosing respiratory failure, 680–681

and flail chest, 464–465

and postoperative ventilatory failure, 681–682
Anesthesia and Perioperative Care of the Combat Casualty

914

lower-airway injury, 528–529

treatment, 529

upper-airway injury, 528

Inhalational anesthesia, 187–207

anesthesia in the field, 205–206

in burn casualties, 535–536

hypotheses of action, 190–193

ideal agent characteristics, 203

and intravenous adjuvants, 228–229

major organ system effects, 203–205

mechanisms of action, 188–190

modern agents, 194–199

and opioid narcotics, 229

site of action, 193

uptake and distribution, 199–202

See also Anesthesia; Anesthesia for casualties of chemical

warfare agents; Anesthetics; Closed-circuit anesthesia;

General anesthesia; Induction of anesthesia

Inhalational anesthetics, 194–199

desflurane, 195, 197–198

enflurane, 195, 196

halothane, 194–195

isoflurane, 195, 196–197

nitrous oxide, 195, 198–199

and pyridostigmine, 850

sevoflurane, 195, 198

See also Anesthetics; Inhalational anesthesia; Military

anesthesia machines

Inhaler, J.T. Clover, 863

Injuries

mechanisms of, 6–8

and metabolic effects, 553–554

nonbattle, 8

and patients’ energy requirements, 561–564

See also Abdominal injuries; Burn injuries; Extremity

injuries; Eye injuries; Face and neck injuries; Metabolic

derangements and nutritional support; Neurological

injuries; Thoracic injuries

Injury severity assessment, 25–28

actual distribution, 27–28

theoretical distribution, 26–27

Injury Severity Score (ISS), 12, 26, 27, 28

Innovar, 223, 887

Inotropic and vasopressor drugs

for sepsis/SIRS/MODS, 635–636

Inspiratory flow rate, 691–692

Inspired oxygen

fraction of, 690–691

Insulin, 546, 547, 548, 578–579

Insulinlike growth factor (IGF-1), 551

Intensity, 5

Intensive care unit

and cardiovascular management, after spinal cord injury, 411

and pain syndromes, after spinal cord injury, 412

and pulmonary management, after spinal cord injury, 411–412

and reasons for neuromuscular blockade, 241

and spinal cord injury management, 407–412

Inter-Allied Surgical Conference, 868–869

Interleukin-1, 554, 555

Interleukin-6, 554, 555

Interleukins

and sepsis/SIRS/MODS, 607

Intermediate hypothermia, 792

Intermittent, mandatory ventilation (IMV), 688

International Red Cross, 288

Intraarterial infusion, 94

Intracranial hypertension

management of, 395–396

during sepsis, 616

See also Oxygen and positive-pressure ventilation

Hypoxia

See Barometric pressure

I

Iatrogenic infection, 112, 612

Ibels, L.S., 720

“ICU ventilators,” 687

Identification tags

and blood type, 355–356

and new policy, 363

Immersion hypothermia, 792

Immobilization

of extremity injuries, 506–507

Immunological aberrations

and burn injuries, 527

and sepsis/SIRS/MODS, 619–620

and surgery in immunocompromised patients with

sepsis/SIRS, 620

and transfusion, 334

See also Immunosuppression

Immunosuppression

and infection, 619

and malnutrition, 620

and transfusion, 334

and trauma, 619–620

See also Immunological aberrations

Immunotherapy

for sepsis/SIRS/MODS, 641–642

Impact Instrumentation, 702

Impact Uni-Vent Model 750 M, 702, 703–704

Induction agents

and pyridostigmine, 849

See also Induction of anesthesia

Induction of anesthesia, 214–221

and airway device placement, 64–65

and barbiturates, 214–215

in burn casualties, 533–534

in casualties with abdominal injuries, 484

and chemical warfare casualties, 845–846

and compromised airway, 533–534

and etomidate, 215–216

and ketamine, 217–221

with open eye injuries, 430–431

and propofol, 216–217

rapid-sequence, 66

and safety, 46

in thoracic casualties, 462

useful drugs, 214–221

See also Induction agents

Infection

definition, 599

transmission, 331–334

See also Infectious diseases; Sepsis

Infection Control Policy and Procedure Guide, 575, 589–596

See also Infectious diseases

Infectious diseases

and evacuation complications, 778

and head trauma, 397–398

and immunosuppression, 619

and patients’ energy requirements, 561–564

See also Bacterial diseases; Fungal infection; Infection; Infection

Control Policy and Procedure Guide; Viral diseases

Inflammatory mediators, 554

Inhalation injury, 528–529

carbon monoxide intoxication, 528
915

Index

Intracranial pressure monitoring, 111–112, 393–394

Intraocular pressure

and drug effects, 429

Intraosseous fluid infusion, 89

Intraperitoneal injuries, 488–493

diaphragm, 493

liver, 492–493

spleen, 493

stomach, small bowel, and colon, 489–492

Intrathecal routes

and analgesic drugs, 315

Intravenous access

in casualties with abdominal injuries, 483–484

and Infection Control Policy and Procedure Guide, 589–596

Intravenous anesthesia, 211–231

agents for battlefield anesthesia, 212–214

anesthetic agents that produce analgesia, 223–227

anxiolytic and amnestic agents, 221–223

with burn casualties, 534–535

and induction drugs, 214–221

and square-root-of-time kinetics, 183–184

techniques, 227–230

total, 220–221, 229, 230

after World War I, 873

during World War II, 877–878

Intravenous fluid-delivery systems, 87–88

Intravenous infusions

and evacuation, 780

Intubation

complications, in trauma patients, 67

failed, and management, 68–72

of head injury casualties, 388

and managing respiratory failure, 682–683

nasotracheal, 64

with open eye injuries, 430–431

orotracheal, 64–65

tracheal, 447–448

Inverse-ratio ventilation (IRV), 689

Iran-Iraq War, 458

and chemical warfare, 835, 836

Iraq

and chemical warfare, 834, 835

Iron, 555, 571

Ischemia

and ARF, 715–716

Ischemic brain injury, secondary, 382–384

Isoflurane, 194, 195, 196–197

See also Anesthetics; Inhalational anesthesia; Military

anesthesia machines

J

Jackson, Charles Thomas, 857

Jackson, Stonewall, 863

Janssen Pharmaceutica Inc., 223, 225, 226

Jaw injuries

See Face and neck injuries

Jenicek, John A., 886, 892, 893

Jet lag

See Fatigue and sleep lag

Jochimsen, F., 720

Joint Medical Readiness Training Command, 49

K

“K” teams, 711, 713

Kaopectate, 583

Keeler, Jill R., 848

Kennedy, A.C., 742

Ketamine, 217–221, 230

and airway management, 73

and burn casualties, 532, 534–535

clinical use, 219–221

contraindications, 219

dose regimen, 215, 228

for major procedures, 220

for minor procedures, 220

for pediatric anesthesia, 221

pharmacology, 217–218

physiological effects, 218–219

as total intravenous anesthetic, 220–221, 230

transport, 220

during Vietnam War, 887

Kevlar helmets, 377

Kidneys

as injury site, 487–488, 489

See also Acute renal failure; Retroperitoneal injuries

Killed in action, 14, 28, 601

in Vietnam War, 15

See also Mortality

Kin-air R beds, 413

Kinetics

See Pharmacokinetics; Square-root-of-time kinetics

King-Seeley Thermos Co., 798

Kinney, Dita H., 865

Klebsiella species, 603, 622

See also Bacterial diseases; Systemic inflammatory

response and multiple organ dysfunction syndromes

(SIRS/MODS)

Kleinknecht, D., 742

Knepshield, J.H., 711

Korean War

and aeromedical evacuation, 758

and ARF, 711

and burn casualties, 522

and military anesthesia, 882–884

and mortality from abdominal wounds, 480

and transfusion practice, 345–346, 357, 883

Krugman, Saul, 332

Kussmaul’s sign, 468

L

Lactic acidosis, 635

Laparotomy, abbreviated

and planned reoperation, 493

Larrey, Baron Dominique-Jean, 753, 754, 758, 789

Laryngeal injury

and airway management, 74–75

See also Airway management; Face and neck injuries

Laryngeal mask airway (LMA), 68–71

Laryngoscope, fiberoptic, 68, 72

Le Fort fractures, 440–441

Lee, H.A., 726

Lethality, 10

Letterman, Jonathan, 753, 758, 862

Leukocyte interactions

and sepsis/SIRS, 621

Leukotrienes, 290, 291, 383

and sepsis/SIRS/MODS, 608

Level 1 Fluid Warmer, 799

Level 1 infusion system, 87

Liano, F., 743

Lichtmann, Manfred (“Dutch”), 885, 886, 888, 889

Lidocaine, 257, 313

and airway management, 73
Anesthesia and Perioperative Care of the Combat Casualty

916

Lower, William E., 253

Lundberg, Nils, 395

Lundberg waves, 395

Lung lacerations, parenchymal, 473, 474

Lymphocytes

and sepsis/SIRS, 621

and SIRS/MODS, 606–607

M

MAC, 195, 202

See also Minimal alveolar concentration (MAC)

MAC-awake, 202, 484–485

Machine gun, 9

Macleod, George H.B., 861

Magill, Ivan Whiteside, 873

Maintenance of anesthesia

in abdominal injury casualties, 484–485

in burn casualties, 534–536

and chemical warfare casualties, 845–846

in thoracic casualties, 462–463

See also Management

Makabali, G.G., 727

Malignant hyperthermia, 811–828

battlefield management, 817–822

battlefield resources, 814–817

clinical signs, 816

clinical syndrome, 812–814

differential diagnosis, 819

evaluation of susceptibility, 826–827

fulminant, 812–813, 817–819

genetic factors, 822

incidence, 822

and inheritance pattern, 822

and masseter muscle rigidity, 813–814

pathophysiology, 823–826

and patient history, 821–822

stress-induced, 814

Malignant hyperthermia cart, 816–817

Malignant Hyperthermia Hotline, 817, 818

Mallampati airway classification, 62

Malnutrition

and immunosuppression, 620

Management

of acid-base disturbances in ARF, 728–730

anesthetic, after head injury, 390–391

anesthetic, after spinal cord injury, 407

anesthetic, after toxic injury, 841–846

of blunt cervical spine injuries, 444–445

cardiovascular, after spinal cord injury, 411

of dialysis, in ARF, 736–741

of electrolyte imbalances in ARF, 730–731

of extremity injuries, 504–506

of head injury, in intensive care unit, 391–397

of intracranial hypertension, 395–396

of malignant hyperthermia, 817–822

phases of, with chemical warfare casualties, 844

pulmonary, after spinal cord injury, 411–412

of pulmonary aspiration, 67–68

and recommended modifications of ATLS, 35

of respiratory failure, 682–683

of spinal cord injury, in intensive care unit, 407–412

of systemic circulation after head injury, 396

of thoracic injuries, 460–463, 464–475

of ventilation after head injury, 396–397

See also Airway management; Prevention and treatment;

Therapeutic measures; Treatment

Mandibular fractures, 440

See also Local anesthetics

Lien, J., 743

Life support

and ethical dilemmas, 685

Lifecare Corporation, 702

Lifecare PLV-100, 687, 702, 703

Lifecare PLV-102, 687, 702, 703

Lifescan Monitor, 112

Lightwand, 68, 72

Lindner, A., 722

Lipids, 546

See also Metabolic derangements and nutritional support;

Metabolites

Lipid hypotheses of inhalational anesthetic action, 190–192

“lipid-phase-transition” hypothesis, 190–192

“membrane-disordering” hypothesis, 190, 191, 192

Lipid-protein interaction hypothesis

of inhalational anesthetic action, 191, 192–193

Lister, Joseph, 863

Liver

as injury site, 492–493

See also Hepatic injury; Intraperitoneal injuries

Local anesthetics, 254–259

and actions on nerve fibers, 306–307

and adverse reactions, 257–259

and allergy, 312

amides, 303, 313

chemical and physicochemical properties, 254–256, 302–304

and clinical pharmacology, 302–312

clinical use, 256, 258

and differential blockade, 307

and dosage, 311

with epinephrine, 309

esters, 303, 312–313

and frequency-dependent blockade, 305–306

individual drug properties, 256–257

and ionization, 304

and lipid solubility, 302

and mode of action, 304–305

and pharmacokinetics, 307–309

and physiology of neural blockade, 256

and protein binding, 304

and receptor sites, 306

selection, 312–313

and toxicity, 310–312

See also Local and regional anesthesia; Regional anesthesia

Local and regional anesthesia

for face and neck injuries, 450

and intravenous adjuvants, 229–230

during World War II, 878

See also Local anesthetics; Regional anesthesia

Locomotion

and regional anesthesia, 261

Logistics and operations, 759–771

of air ambulance, 761

of air evacuation, 760–761

organization of, by U.S. Army, 760–761

and corps and communications zones, 763–768

and domestic aeromedical evacuation system, 768–771

and evacuation priority assignments, 761–763

of ground evacuation, 759–760

and pace, 45

during Persian Gulf War, 44

and support, 44

Lohr, J.W., 743

Long, Crawford W., 857, 859

Look-Back Program, 333

Lordon, R.E., 711
917

Index

Manganese, 572

Manhattan Project, 194

Mannitol, 722

Manual in-line axial traction (MIAT), 406

Marine Surgical Data Base, 836–837

Marion Merrell Dow, 37, 650

MASH

See Korean War; Mobile Army Surgical Hospital (MASH)

Mask ventilation, 447

Massachusetts General Hospital, 861

Masseter muscle rigidity, 813–814

differential diagnosis, 821

and therapeutic cooling, 820–821

Maxillary fractures, 440–441

Maxillofacial injury

and airway management, 74

and evacuation complications, 778

See also Airway management; Face and neck injuries

McFarlane, M.J., 743

McGrigor, James, 753

McKesson Appliance Co., 142

McKesson model, 142, 675, 875, 878, 883

See also Equipment; Military anesthesia machines

McMurray, S.D., 742

Meals ready to eat (MREs), 572

Mechanical trauma

and pulmonary insufficiency, 669–671

Mechanical ventilation

and combat casualties, 685–689

complications, 684–685

indications, 686

initiating, 690–692

monitoring, 692–698

physiological effects, 683–684

and positive-pressure modes, 687–689, 691

weaning from, 699–702

See also Ventilation; Ventilators for combat use; Ventilatory failure

Medical education

See Education of personnel

Medical Force 2000 (MF2K), 134–138

augmentation teams, 137

combat support, field, and general hospitals, 137

Forward Surgical Team (FST), 135–137

hospital ships, 137–138

Mobile Army Surgical Hospital, (MASH), 134–135

Medical gas, 123–124, 149–151

See also Gas anesthesia; Military anesthesia machines

Medical Logistics, 123

Medical Logistics Battalion, 133

Medical material sets (MMSs), 122

Medical network

complexity of, 44–45

Medical outcome of combat injury, 13–31

died of wounds, 14–16

“golden hour,” absence of, in combat trauma, 16–17

historical trends in combat mortality, 17–18

injury severity assessment, 25–28

killed in action, 14

morbidity, 23–24

pathophysiological causes of death, 28–31

for specific body-region injuries, 18–22

Medical Readiness Task Force, 135

Medical reengineering initiative (MRI), 134, 137–138

Medical Service of the Army of the Soviet Union, 57

Medications, preoperative

for burn casualties, 532

MEDSOM (Medical Supply, Optical, and Maintenance)

Battalion, 133

Meirowsky, Arnold M., 379, 380

Melatonin, 775

Meperidine, 224, 225

as adjuvant to inhalational anesthesia, 229

and clinical pharmacology, 297

and side effects, 297

and shivering, 800

Mepivacaine, 257, 313

See also Local anesthetics

Merkava, 759

Merrill, J.P., 712, 742

Mesmer, Franz Anton, 857

Metabolic derangements and nutritional support, 543–596

effect of injury, 553–554

energy requirements of patients with injuries or infections,

561–564

exercise, 549–551

Infection Control Policy and Procedure Guide, 575, 589–596

metabolic derangements in combat casualties, 549–564

nutritional support, 565–585

starvation, 549

starvation, exercise, and stress, 551–553

stress response stages, 554–561

See also Metabolism and nutrition; Nutrition

Metabolic effects

of established multiple organ failure, 648–649

of hypothermia, 796

See also Metabolic derangements and nutritional support

Metabolic and endocrinological responses

to sepsis/SIRS/MODS, 619

See also Metabolic derangements and nutritional support

Metabolic manipulations

for sepsis/SIRS/MODS, 643–644

Metabolic terminology, 547

“Metabolic tide,” 555

Metabolism

of local anesthetics, 309

and responses to trauma, 294

and secondary pain manifestations, 294

See also Metabolic derangements and nutritional support

Metabolism and nutrition

and burn injuries, 527

See also Metabolic derangements and nutritional support

Metabolites, 545–548

Methohexital

dose regimen, 215

Meyer, Hans H., 188, 190

Meyer-Overton rule, 188, 189, 305

Mezlin, 483

See also Antibiotics

MF2K

See Medical Force 2000 (MF2K)

Microbiologic evaluation

of sepsis/SIRS/MODS, 624–625

Microvascular bleeding (MVB), 327

Midazolam

dose regimen, 215

See also Benzodiazepines

Militarily unique considerations, 354–359

female casualties and Rh blood groups, 356, 357

group-specific transfusion and random-mix blood, 354–355

identification tags, 355–356

research efforts, 356, 358

Military anesthesia machines, 141–174

Field Anesthesia Machine (FAM) Model 885A, 142, 143–165
Anesthesia and Perioperative Care of the Combat Casualty

918

future recommendations, 170–173

Ohmeda Universal Portable Anesthesia Circuit (PAC),

165–170

rebreathing, 873

See also Equipment; Face masks

Military antishock trousers (MAST), 93

Military Blood Program 2004 Study, 130

Military experience

and ARF, 710–713

and battlefield medical environment, 44–46

and organization for provision of care, 32–33

and pyridostigmine, 850

and sepsis/SIRS/MODS, 600–601

Military medical evacuation, 751–783

aeromedical, and biophysical effects, 771–775

history, 752–759

logistics and operations, 759–771

medical determinants of safety, 775–782

preparation for, 779–782

See also Evacuation

Military transfusion practice, 341–373

blood-distribution system: interaction guidelines,

369–373

blood transfusion at second echelon, 342, 344–351

during Korean War, 345–346, 883

militarily unique considerations, 354–359

during Persian Gulf War, 346, 357, 361–363

planning and training, 360–363

transfusion support at third and fourth echelons, 342,

351–354

during Vietnam War, 346, 357, 483

during World War I, 871–872

during World War II, 345, 355, 357, 361

See also Blood transfusions; Transfusion therapy

Minerals, replacement, 567–571

Minimal alveolar concentration (MAC), 195, 202

MiniStim, 237

Missile wound distribution

by body surface, 10–11

Mivacurium chloride, 245

See also Nondepolarizing muscle relaxants

Mobile Aeromedical Staging Facility (MASF), 763

Mobile Army Surgical Hospital, (MASH), 118, 134–135

Modified Brooke Formula, 524

Mon-a-therm, Inc., 789

Monitoring

during aeromedical evacuation, 782

brain, 391–392, 394

of burn casualties, 524–525, 532–533

of cardiovascular system, 106–109

of casualties with abdominal injuries, 484

cerebral blood flow, 393

and computers in anesthesia, 113

in echelons of care, 102–105

electroencephalographic, 393

of enteral nutrition, 583

and extremity injuries, 515

gas-exchange indices, 693–694

hemodynamic, 698

of hemostasis and coagulation, 105–106

intracranial pressure, 111–112, 393–394

intraoperative, 515

jugular venous bulb, 384

mechanical ventilation, 694–698

metabolic, of brain, 394

of nervous system, 111–113

oxygen concentration, 692

perioperative, 484

physiological, 101–113

pulse oximetry, 692–693

of renal system, 111

of respiratory system, 109–111

of resuscitation, 524–525

systemic, 105–113

of temperature, 113

of thoracic casualties, 462

See also Diagnosis and monitoring of patients with sepsis/

SIRS; Monitors

Monitoring techniques, neuromuscular, 237–240

clinical assessment, 239

double-burst stimulation, 239

single twitch, 238, 240

tetanic stimulation, 239, 240

train-of-four, 238–239, 240

See also Monitoring; Physiological monitoring

Monitors

cerebral, and evoked potentials, 392–393

cerebral, operational characteristics, 392–394

for chemical agents, 839–840

in first and second echelons, 102–104

in fourth echelon and higher, 105

physiological, 123

and sepsis/SIRS/MODS, 625–627

in third echelon, 104–105

See also Equipment; Monitoring; Physiological monitoring

Monocytes

and sepsis/SIRS, 621

Monokines

and sepsis/SIRS/MODS, 607

Mononuclear cells

and SIRS/MODS, 605–606

Morale, 52

See also Education of personnel; Personnel

Morbidity, 13, 23–24

indices, 23

Morphine, 225, 861, 863

as adjuvant to inhalational anesthesia, 229

and clinical pharmacology, 295–296

first isolated, 294

and physical dependence, 296

and resuscitation, 879

and side effects, 295–296

Mortality, 13–16

and anesthesia, 881

and ARF, 712, 713

cause of, after spinal cord injury, 408

determination, 803

and historical trends in combat, 17–19

among medical personnel, 52

and pathophysiological causes, 28–31

and traumatic injury, 601

See also Death; Died of wounds; Killed in action

Morton, William T.G., 165, 857, 859, 860

Morton inhaler, 165

MRI

See Medical reengineering initiative (MRI)

Multiple organ dysfunction syndrome (MODS)

See Multiple organ failure, established; Systemic inflammatory response and multiple organ dysfunction

syndromes (SIRS/MODS)

Multiple organ failure, established, 644–652

clinical manifestations, 648–651

definition, 645

etiology and pathophysiology, 647–648

mortality risk, 646

prevalence, 644–645
919

Index

prognosis, 645–647

treatment modalities, 651–652

See also Systemic inflammatory response and multiple

organ dysfunction syndromes (SIRS/MODS)

Munitions, explosive, 8–9

Muscle (masseter) rigidity, 813–814

differential diagnosis, 821

and therapeutic cooling, 820–821

Muscle relaxants, 242–245

atracurium besylate, 244–245

investigational agents, 245

mivacurium chloride, 245

pancuronium bromide, 243

rocuronium bromide, 245

succinylcholine chloride, 242–243

vecuronium bromide, 243–244

See also individual entries

MUST (medical unit, self-contained, transportable) hospital,

118–119

Mutation of ryanodine-receptor gene

in malignant hyperthermia, 826

See also Genetic factors

Muzzle velocity, 9

Myocardial depressant factor

and sepsis/SIRS/MODS, 614

Myocardial dysfunction

and sepsis/SIRS/MODS, 612–614

N

Nalbuphine, 227

and clinical pharmacology, 298

Naloxone, 227

and clinical pharmacology, 298

for sepsis/SIRS/MODS, 643

Napoleon, 3, 6

Narcan, 227

See also Naloxone

Nasal fractures, 440

Nasogastric tubes

and evacuation, 780

Nasotracheal intubation

and airway device placement, 64

See also Intubation

National Research Council, 871

Nature of combat injury, 6–13

mechanisms of injury, 6–8

missile wound distribution, by body surface, 10–11

nonbattle injury, 8

and service-specific aspects, 8

sources of penetrating missiles, 8–10

wound depth, 11–13

Neck injuries, 441–443

airway injuries, 441–442

esophageal injuries, 442–443

nerve injuries, 442

vascular injuries, 442

See also Face and neck injuries

Needle, soft metal, 873

Neisseria meningitidis, 622, 622

See also Bacterial diseases; Systemic inflammatory

response and multiple organ dysfunction syndromes

(SIRS/MODS)

Nembutal, 873

Nerve agents

and pulmonary insufficiency, 672–673

See also Anesthesia for casualties of chemical warfare

agents

Nerve block techniques

ankle block, 281–282

Bier’s method, 275–276

brachial plexus block, 272–274

cervical plexus block, 267–269

femoral nerve block, 278

intravenous regional anesthesia, 275–276

lateral femoral cutaneous nerve block, 280–281

for lower extremity surgery, 276–282

lumbar plexus block, 276–278

mandibular nerve block, 270

maxillary nerve block, 270

occipital nerve block, 269

and ocular nerves, 270–271

sciatic nerve block, 278–279

at the popliteal fossa, 279

sole-anesthetic nerve blocks

for lower extremity surgery, 276–282

superior laryngeal nerve block, 271

transtracheal block, 271

trigeminal nerve block, 270

for upper extremity surgery, 271–276

Winnie 3-in-1 paravascular approach, 276, 277

See also Nerve blocks; Neural blockade; Regional anesthesia

Nerve blocks

and airway device placement, 63–64

and techniques, 267–282

See also Nerve block techniques; Neural blockade; Regional

anesthesia

Nerve compression, supraorbital, 432

Nerve fibers

and actions of local anesthetics, 306–307

classification, 291

pathways, 292

Nerve injuries

with face and neck injuries, 442

See also Neurological injuries

Nerve stimulation

double-burst stimulation, 239

single twitch, 238, 240

tetanic stimulation, 239, 240

train-of-four, 238–239, 240

Nervous system, monitoring, 111–113

central, 111–112

peripheral nerve stimulators, 112–113

See also Central nervous system

Neural blockade

benefits, 252–254

physiology, 256

See also Nerve blocks; Nerve block techniques; Regional

anesthesia

Neural temperature control, 789

Neurological abnormalities

and uremia, 738

Neurological injuries, 375–414

and evacuation complications, 778

with face and neck injuries, 445–446

head injuries in combat, 376–378

head trauma: medical complications, 397–398

neurosurgical intervention: goals, 379–381

spinal cord injury, 399–413

traumatic brain injury: pathological anatomy and physiology, 382–386

traumatic brain injury: patient care, 387–397

traumatic brain injury: recovery and outcome, 398

See also Central nervous system; Face and neck injuries

Neurological manifestations

of sepsis/SIRS/MODS, 618–619
Anesthesia and Perioperative Care of the Combat Casualty

920

See also Central nervous system; Neurological injuries;

Neurological system

Neurological system

and cervical spine injury, 402

and complications of anesthesia by toxic agents, 846–847

and responses to trauma, 294

and uremia, 738

See also Central nervous system; Neurological manifestations

Neurometrics Inc., 112

Neuromuscular blockade

complications, 246

indications, 241–242

and reversal agents, 244

Neuromuscular blocking agents, 235–247

blockade complications, 246

blockade indications, 241–242

monitoring techniques, 237–240

muscle relaxants, 242–245

and pyridostigmine, 849

Neuromuscular monitoring

and pyridostigmine, 850

techniques, 237–240

Neuropathy, peripheral

and sepsis/SIRS, 618–619

Neurosurgical intervention

goals, 379–381

Neutropenia

and sepsis/SIRS, 621

Neutrophil morphology

and sepsis/SIRS, 621

Neutrophilia

and sepsis/SIRS, 621

New York World’s Fair (1939), 873

Nightingale, Florence, 753

Nines, Rule of

See Rule of Nines

Nitrous oxide, 194, 195, 198–199

in casualties with abdominal injuries, 485

in dental operations, 863

in military surgery, 869–870

and oxygen, 869–870, 872

and patients in shock, 872

during World War I, 868

during World War II, 878

See also Anesthetics; Inhalational anesthesia; Military

anesthesia machines

Noise and vibration

and biophysical effects, 775, 778

Nonbattle injury, 8

Nondepolarizing agents, 236

and eye injury, 74

muscle relaxants, 243–245

and pyridostigmine, 849–850

and rapid tracheal intubation, 66

Nonimmersion hypothermia, 792

Nonoliguric, 716

Nonsteroidal antiinflammatory drugs (NSAIDs), 290, 293

and analgesia, 300

and antiinflammatory effect, 301

and antipyresis, 300

and clinical pharmacology, 298–302

and pharmacokinetic data, 300

and side effects, 301–302

specific agents, 299

Norepinephrine

in refractory septic shock, 636

Nose injuries

See Face and neck injuries

Nosocomial infections

pneumonia, 639–640

prevention of, with sepsis/SIRS, 639–640

after spinal cord injury, 411

See also Sepsis; Systemic inflammatory response and

multiple organ dysfunction syndromes (SIRS/MODS)

Nubain, 227

See also Nalbuphine

Nuclear warfare

and pulmonary insufficiency, 673

Nurses, 865

as anesthetists, 867, 873

See also Education of personnel; Personnel

Nutrition

and burn casualties, 527

See also Metabolic derangements and nutritional support

Nutritional support, 565–585

for ARF, 726–728

assessment of nutrition, 565–567

assessment of nutritional repletion, 584–585

enteral nutrition, 579–584

and immunosuppression, 620

and Infection Control Policy and Procedure Guide, 589–596

parenteral nutrition, 567–579

after spinal cord injury, 413

See also Malnutrition; Metabolic derangements and

nutritional support

O

Obstruction, airway, 57, 75

Ocular injuries, 446

See also Eye injuries

Oculocardiac reflex, 432–433

Ohio Model 785 Field Anesthesia Machine, 142, 889–892

See also Equipment; Military anesthesia machines

Ohio Model 855A Field Anesthesia Machine, 104, 142

in the field, 205–206

See also Equipment; Military anesthesia machines

Ohio Monovalve anesthesia apparatus, 867, 868

See also Equipment; Military anesthesia machines

Ohmeda, Inc., 104

See also Equipment; Military anesthesia machines

Ohmeda Universal Portable Anesthesia Circuit (PAC), 143,

165–171, 176

checkout and maintenance, 170

in the field, 205–206

and future recommendations, 170–171

specifications and operation, 166–170

See also Equipment; Military anesthesia machines

Oliguria, acute

vs ARF, 716–717

definition, 716

diagnosis, 716

and pharmacological therapy for, 724

Open-drop ether, 878

See also Ether

Open head injury, 376, 378

Operation Just Cause (Panama)

and evacuation scheme, 45, 776–777

Operation Restore Democracy

evacuation scheme, 45

Operations

See Logistics and operations

Ophthalmic complications, perioperative, 432–433

acute angle-closure glaucoma, 432

corneal abrasion, 432

oculocardiac reflex, 432–433
921

Index

retinal artery thrombosis, 432

supraorbital nerve compression, 432

Ophthalmic injuries

See Eye injuries; Ocular injuries

Ophthalmological manifestations

of sepsis/SIRS/MODS, 623

Opiate antagonists

and spinal cord protection, 409

See also Opioid antagonist drugs

Opioid, 224, 293

Opioid agonist-antagonist drugs, 226–227

butorphanol, 227

and clinical pharmacology, 297–298

nalbuphine, 227

and physiological effects, 226–227

See also individual entries

Opioid agonist drugs, 224–226

alfentanil, 226

and clinical pharmacology, 295–297

fentanyl, 225–226

meperidine, 225

morphine, 225

and physiological effects, 224–225

sufentanil, 226

See also individual entries

Opioid analgesics

and clinical pharmacology, 294–298

Opioid antagonist drugs, 227

naloxone, 227

and physiological effects, 227

See also Naloxone; Opiate antagonists

Oral supplements, 580–581

Organ bed changes

and response to stress, 557

Organ failure

See Multiple organ failure, established

Organ-specific responses to sepsis/SIRS/MODS, 611–623

cardiovascular response, 611–614

dermatological and ophthalmological manifestations, 623

hematological and coagulation defects, 620–623

immunological aberrations, 619–620

metabolic and endocrinological responses, 619

neurological manifestations, 618–619

pulmonary response, 614–616

renal dysfunction, 616–617

surgery in immunocompromised patients with sepsis/

SIRS, 620

Organ system effects

of hypothermia, 792–796

of potent inhaled agents, 203–205

Organ-system responses

to head injury, 384–386

Organophosphate poisoning

and nondepolarizing neuromuscular blocking agents, 847

and protection by pyridostigmine, 848

Orotracheal intubation

and airway device placement, 64–65

See also Intubation

Orthopedic injuries

and evacuation complications, 778

Osborne wave, 794

Ovassapian intubating airway, 72

Overton, Charles E., 188, 190

Oxidative metabolic shifts

and response to stress, 558–559

Oxygen

and nitrous oxide, 869–870

therapeutic, 60, 93–94

See also Oxygen concentration; Oxygen delivery and

consumption; Oxygen and positive-pressure ventilation;

Oxygenation

Oxygen adjuncts, 60

See also Oxygen and positive-pressure ventilation

Oxygen concentration

monitoring, 160–163, 692

See also Oxygenation

Oxygen delivery and consumption

during aeromedical evacuation, 781–782

monitoring, 696–697

in patients with injury or infection, 563

and sepsis/SIRS/MODS, 633–635

See also Metabolic derangements and nutritional support;

Oxygen transport; Oxygenation

Oxygen flush valve, 158, 160

Oxygen monitor, 160–163, 692

Oxygen and positive-pressure ventilation, 177–179

conserving oxygen, 178–179

leaks, inward and outward, 177–178

See also Oxygenation

Oxygen regulator, 151

Oxygen transport

and hemorrhage, 84–85

and transfusion therapy, 325–326

See also Oxygen delivery and consumption

Oxygenation

and biophysical effects, 773–774

monitoring, 692–698

P

Pacemaker

See Equipment; Monitors

Paceport pulmonary artery catheter, 573, 575

Packed red blood cells, group O

field use, 346, 347, 349

See also Military transfusion practice; Transfusion therapy

Pain

receptors, 290

transmission of, 291–292

transmitters, local, 290–291

See also Pain syndromes; Perioperative pain

Pain syndromes

after spinal cord injury, 412

See also Perioperative pain

Panama invasion

and medical problems during evacuation, 776–777

Pancreas

as injury site, 488

See also Retroperitoneal injuries

Pancuronium bromide, 243

See also Nondepolarizing muscle relaxants

Pancytopenia

and sepsis/SIRS, 620–621

See also Hematological and coagulation defects

Papaver somniferum, 294

Parasympathetic nerves

and regional anesthesia, 260

Parenchymal lung lacerations, 473, 474

Parenteral nutrition, 527; 567–579

guidelines, 569–570

and Infection Control Policy and Procedure Guide, 589–596

and insulin, 578–579

and order forms, 568–570

peripheral, 578

replacement minerals, 567–571

total, and complications, 575, 576
Anesthesia and Perioperative Care of the Combat Casualty

922

total, and delivery, 572–575

total, and modifications, 575–578

trace elements, 571–572

vitamins, 572

See also Enteral nutrition; Metabolic derangements and

nutritional support;

Parkland Formula, 524, 525

Parsons, E., 874

Partition coefficients, 200

Pass, L.J., 722

Pathogenesis of ARF, 713–716

cellular injury, 715–716

tubular mechanisms, 715

vascular mechanisms, 714–715

Pathophysiological causes of death, 28–31

Pathophysiology

of abnormal gas exchange, 678

of burn injuries, 526–527

of established multiple organ failure, 647–648

of fat embolism syndrome, 510–512

of malignant hyperthermia, 823–826

of pain, 290–293

of pulmonary problems with sepsis/SIRS, 615–616

of traumatic brain injury, 382–386

Patient-controlled analgesia (PCA), 290, 313–314

Patient Evacuation Form DD 602 or 1380, 778, 780

Patil-Syracuse mask, 72

Pediatric anesthesia

and ketamine, 221

Penetrating injury

of brain, 382

of head, 376–377, 380–381

and pulmonary insufficiency, 669

See also Neurological injuries

Penetrating missiles

and abdominal injury, 22

and chest injury, 20–21

and extremity injury, 22

and head injury, 20

and resulting wounds, 376–377

sources of, 8–10

and thoracic trauma, 456–457

See also Injuries, mechanisms of

Penicillin, 881

See also Antibiotics

Penlon, Ltd., 165

Perfusion

See Peripheral perfusion

Pericarditis, uremic, 738

See also Acute renal failure (ARF); Cardiovascular system

Perioperative anesthetic management, 449–451

in casualties with abdominal injuries, 484, 484–485

and general anesthesia, 450–451

and intraoperative airway management, 451

and local and regional anesthesia, 450

and postoperative airway management, 451

See also Perioperative pain

Perioperative considerations with burn casualties, 531–537

anesthetic technique, 533–536

intraoperative fluid management, 536

monitoring, 532–533

postanesthetic considerations, 537

preoperative assessment, 532

preoperative medications, 532

temperature regulation, 536–537

transport, 533

Perioperative considerations in casualties with abdominal

injuries, 483–485

antibiotics, 483

coexisting disease and monitoring, 484

induction of anesthesia, 484

intravenous access, 483–484

maintenance of anesthesia, 484–485

nitrous oxide, 485

positioning for operation, 485

Perioperative pain, 287–316

analgesic drugs: mode of administration, 313–316

local anesthetics: clinical pharmacology, 302–312

local anesthetics: selection, 312–313

nonsteroidal antiinflammatory drugs (NSAIDs): clinical

pharmacology, 298–302

opioid analgesics: clinical pharmacology, 294–298

pathophysiology of pain, 290–293

and secondary systemic manifestations, 293–294

See also Perioperative anesthetic management; Perioperative considerations with burn casualties; Perioperative

considerations in casualties with abdominal injuries

Peripheral nerve stimulators, 112–113

Peripheral nervous system

and toxic injury, 841

Peripheral parenteral nutrition (PPN), 578

Peripheral perfusion

maintenance of, in burn casualties, 525

Peritoneal dialysis, 734–735

See also Dialysis

Permeability pulmonary edema, 675

See also Acute respiratory failure and ventilatory management

Pernick, Martin S., 863

Persian Gulf War

and chemical warfare, 834

and deployable hospitals, 132–134

and evacuation scheme, 45

and mechanical ventilators, 687, 699

and medical network, 44

and medical problems during evacuation, 776–777

and military anesthesia machines, 143, 152, 157, 166

and open head injuries, 377–378

and pulse oximeters, 693

and pyridostigmine, 97

and technology and logistics, 44

and transfusion practice, 346, 357, 361–363

Personnel

in battlefield hospitals, 47–53

on hospital ships, 137

in Medical Force 2000, 134

recruitment, 882

role, 47–53, 879, 892–893

during Spanish-American War, 865–866

during Vietnam War, 885, 889, 892

during World War I, 866–867

during World War II, 874–875, 879

See also Dentists; Education of personnel; Nurses; Physicians

pH-stat management, 797

See also Acid-base balance

Pharmacokinetics

definition, 307

of local anesthetics, 307–309

of potent volatile anesthetics, 180–181

See also Square-root-of-time kinetics

Pharmacological effects

of intravenous anesthetic agents, 213

See also Drug effects; Drug interactions

Pharmacological interactions

See Drug interactions
923

Index

Pharmacological uncertainty principle, 182

Pharmacology

of adjunct medications, 298

of barbiturates, 214

of butorphanol, 297–298

of dezocine, 298

of droperidol, 298

of etomidate, 215

of fentanyl, 296–297

of ketamine, 217–218

of local anesthetics, 302–312

of meperidine, 297

of mixed agonists, 298

of morphine, 295–296

of nalbuphine, 298

of naloxone, 298

of nonsteroidal antiinflammatory drugs (NSAIDs),

298–302

of opioid agonists, 295–297

of opioid agonist-antagonists, 297–298

of opioid analgesics, 294–298

of promethazine, 298

of propofol, 216–217

of pyridostigmine, 847–848

Phemister, D.E., 874

Philadelphia collar, 405–406

Phillips, Thomas, 858

Phillips, W.J., 549

Phosgene, 673

See also Choking agents

Phosphate abnormalities

in ARF, 730–731

Phosphocholine lecithin, 190

Phosphorus, 567, 568, 570, 571

Physician’s orders

and air evacution, 779–780

Physicians

during Korean War, 882–883

recruitment, 882

See also Personnel

Physiologic Effects of Wounds, The, 86

Physiological effects

of barbiturates, 214–215

of droperidol, 223

of etomidate, 215–216

of ketamine, 218–219

of opioid agonist-antagonist drugs, 226–227

of opioid agonist drugs, 224–226

of opioid antagonist drugs, 227

of propofol, 217

of scopolamine, 222

Physiological monitoring, 101–113

computers in anesthesia, 113

monitors in echelons of care, 102–105

systemic monitoring, 105–113

See also Monitoring; Monitors

Pig, 142, 876, 883

See also Equipment; Military anesthesia machines

Pin-index safety system (PISS), 148, 149, 150–152

Pirogov, Nikolai I., 5, 752

Placement of airway devices, 62–66

airway classification, 62

anesthetizing the airway, 62–63

nasotracheal intubation, 64

nerve blocks, 63–64

orotracheal intubation, 64–65

rapid-sequence induction of anesthesia, 66

See also Intubation

Planning and training, 360–363

adjustments from civilian medicine, 360–361

hands-on practice, 361–362

planning at third and fourth echelons, 363

second-echelon transfusion strategy, 362–363

Plasma, 322, 874, 880, 881, 883

fresh frozen, 326, 328, 329

See also Blood; Blood products; Military transfusion

practice; Transfusion therapy

Plateau pressure, 111

Plateau wave, 396

Platelet activating factor

and sepsis/SIRS, 610

Platelet dyscrasia

and sepsis/SIRS, 622–623

Platelets

and dilutional thrombocytopenia, 327–328

and the future, 359

See also Blood; Blood products; Hemostasis and coagulation; Military transfusion practice; Pathophysiology;

Transfusion therapy

Pneumatic antishock garments (PASGs), 93

and aeromedical evacuation, 772

Pneumothorax, 471–472, 669, 772

See also Acute respiratory failure and ventilatory management

Polson, R.J., 723

Polymorphonuclear cells

and SIRS/MODS, 606

Polyuria, 716

POMCUS (prepositioned material configured in units), 132

Porter, John B., 860

Positioning the patient

for surgery, 463, 485

as therapeutic measure, 92–93

Positive-pressure ventilation, 687–689

continuous, positive airway pressure (CPAP), 689

expiratory positive pressure, 689

inspiratory positive pressure, 687–689

and oxygen, 177–179

positive end-expiratory pressure (PEEP), clinical use, 689

Postanesthesia care treatment

for hypothermia, 799–800

Postanesthetic considerations

with burn casualties, 537

Postoperative care

of thoracic casualties, 463

Potent volatile anesthetics, 179–184

administration equipment, 182–183

concentration and dosage, 181–182

intravenous agents: square-root-of-time kinetics, 183–184

pharmacokinetics, 180–181

pharmacological uncertainty principle, 182

See also Anesthetics

Pralidoxime chloride (2-PAM Cl), 673

Premedication

with pyridostigmine, 848, 849

Preoperative evaluation and preparation

of burn casualties, 532

of thoracic casualties, 460–462

Pressure reversal

in general anesthetics, 189, 190, 192

Pressure support (PS) ventilation, 688

Pretreatment

with pyridostigmine, 848, 849

Prevalence

of established multiple organ failure, 644–645

Prevention and treatment, 797–800
Anesthesia and Perioperative Care of the Combat Casualty

924

algorithm, 802

and ARF, 719–724, 724–726

blood and fluid warmers, 799

for patients at high risk for ARF, 719–721, 724–726

postanesthesia care unit treatment, 799–800

supplemental warming devices, 798–799

See also Management; Therapeutic measures; Treatment

Priestley, Joseph, 857

Prilocaine, 257, 313

See also Local anesthetics

Primary hypothermia, 792

PRIMOB (primary mobilization stations), 132

Procaine, 312, 878

and 2-chloroprocaine, 312

See also Anesthetics

Prognosis

in established multiple organ failure, 645–647

and outcome, of ARF, 741–744

See also Medical outcome of combat injury

Promethazine

and clinical pharmacology, 298

PROPAC 104, 107

PROPAQ monitors, 124, 788–789

Propaq Systems, 124

Propofol, 216–217

clinical use and contraindications, 217

dose regimen, 215

pharmacology, 216–217

physiological effects, 217

used as total intravenous anesthetic, 230

Prostacyclin, 301

and sepsis/SIRS/MODS, 608–609

Prostaglandins, 291, 293, 383

and sepsis/SIRS/MODS, 608, 609

See also individual organ systems

Protection, detection, and decontamination

and toxic agents, 839–840

Protein

normal turnover, 548

in response to stress, 559–561

See also Metabolic derangements and nutritional support;

Metabolites

Protein hypothesis

of inhalational anesthetic action, 191, 192

Protocol Systems, Inc., 107

Pseudocholinesterase anomaly

and neuromuscular blockade effect, 245

Pseudomonas aeruginosa, 603, 622

See also Bacterial diseases; Systemic inflammatory

response and multiple organ dysfunction syndromes

(SIRS/MODS)

Psychiatric illness

and medically safe evacuation, 779

Psychic upset

and anesthesia, 872

Pulmonary artery catheterization, 108–109

purposes of, with extremity injuries, 514

in sepsis/SIRS, 625–626

and total parenteral nutrition, 573–575

Pulmonary artery pressure

monitoring, 108–109

Pulmonary aspiration

management, 67–68

and respiratory insufficiency, 674–675

Pulmonary edema, 675–676

See also Acute respiratory failure and ventilatory management

Pulmonary embolism

See Deep venous thrombosis and pulmonary embolism

Pulmonary function

monitoring, 111

See also Respiratory system

Pulmonary insufficiency

etiology, 669–673

See also Pulmonary pathophysiology

Pulmonary pathophysiology

and burn injuries, 526–527

See also Acute respiratory failure and ventilatory management; Pulmonary insufficiency; Respiratory system

Pulmonary response

to sepsis/SIRS/MODS, 614–616

See also Acute respiratory failure and ventilatory management; Respiratory system

Pulmonary system

and established multiple organ failure, 649

and head injury, 384–385

and head trauma, 397–398

and management, after spinal cord injury, 411–412

and mechanical ventilation effects, 683

and sepsis/SIRS/MODS, 614–616

and spinal cord injury, 403

See also Acute respiratory failure and ventilatory management; Respiratory system

Pulse oximetry

monitoring, 104, 109–110, 692–693

Punic War, Second, 752

Purdue Frederick, 483

Puritan-Bennett Companion, 687

Puritan-Bennett PR-2, 686–687, 702–703

Pyridostigmine, 847–850

and depolarization block, 849

and induction agents, 849

and inhalational anesthetics, 850

and military experience, 850

and neuromuscular blocking agents, 849

and neuromuscular monitoring, 850

and nondepolarizing agents, 849–850

pharmacology, 847–848

premedication with, 849

and resuscitating combat casualties, 97

Q

Quarterly Supplement of Anesthesia and Analgesia, 866

R

Radiation

and normal thermoregulation, 790

Radiography

of the chest, 698

Radiological evaluation

in sepsis/SIRS, 627–628

of spinal cord injury, 404–406

Radiological procedures

and sepsis/SIRS/MODS, 627–628

Radionuclide cineangiography, 613

Rapid Deployment Hospital Ship program, 756

Rapid-sequence intravenous induction, 227–228

Rasmussen, H.H., 720

Rebreathing machine, 873

See also Acute respiratory failure and ventilatory management; Military anesthesia machines

Receptors, 290

sites, 306
925

Index

Recrudescence

of hyperthermia, 819

Rectum

as injury site, 492

See also Intraperitoneal injuries

Recurarization, 239

See also Curare

Regional anesthesia, 251–282

of airway, 271

and extremity injuries, 513–514

vs general anesthesia, 253

of head and neck, 267–271

and intravenous adjuvants, 229–230

local anesthetics, 254–259

nerve block techniques, 267–282

neural blockade, and benefits, 252–254

and physiological benefits, 252

for thoracic and abdominal surgery, 259–267

during Vietnam War, 887–888

during World War II, 878

See also Anesthesia; Anesthesia for casualties of chemical

warfare agents; Anesthetics; Closed-circuit anesthesia;

General anesthesia; Inhalational anesthesia; Intravenous

anesthesia; Local anesthetics; Local and regional

anesthesia

Regurgitation and aspiration, 67, 75

Renal dysfunction

and sepsis/SIRS/MODS, 616–617

See also Acute renal failure; Renal system

Renal failure

and modifications of parenteral nutrition, 575–577

See also Acute renal failure; Renal dysfunction; Renal

system

Renal system

and hypothermia, 795–796

and mechanical ventilation effects, 684

monitoring, 111

and NSAIDs, 301

and potent inhaled agents, 205

See also Acute renal failure; Kidneys; Renal dysfunction

Respiratory failure in combat casualty care

definition, 680

diagnosis, 680–682

epidemiology, 669

etiology, 668

management, 682–683

and modifications of parenteral nutrition, 578

See also Respiratory insufficiency; Respiratory system

Respiratory insufficiency

and ARDS, 676–680

and hydrostatic pulmonary edema, 675–676

and pulmonary aspiration, 674–675

See also Respiratory failure in combat casualty care;

Respiratory system

Respiratory support

during aeromedical evacuation, 781–782

Respiratory system

and barbiturates, 214–215

and benzodiazepines, 222

and complications of anesthesia by toxic agents, 846

and etomidate, 216

and ketamine, 219

monitoring, 109–111

and morphine, 295

and NSAIDs, 301

and opioid agonist drugs, 224–225

and potent inhaled agents, 203

and regional anesthesia, 260

and secondary pain manifestations, 293

and sepsis/SIRS/MODS, 636–637

and systemic hypothermia, 794

and toxic injury, 841, 842

See also Acute respiratory failure and ventilatory management; Pulmonary function; Pulmonary insufficiency;

Pulmonary pathophysiology; Pulmonary response;

Pulmonary system; Respiratory failure in combat

casualty care; Respiratory insufficiency

Resting energy expenditure (REE), 549

See also Metabolic derangements and nutritional support

Resuscitation

equipment, 123

formulas, 524

monitoring of, in burn casualties, 524–525

during World War II, 878–881

Resuscitation fluid selection, 89–92

advantages and disadvantages, 90

colloid solutions, 91

crystalloid solutions, 89–91

hypertonic solutions, 91–92

for sepsis/SIRS/MODS, 631–633

See also Colloid solutions; Crystalloid solutions

Retinal artery thrombosis, 432

Retinol-binding protein

and nutritional repletion, 585

Retrobulbar block, 446

Retroperitoneal injuries, 486–488

great vessels, 487

kidneys, ureters, and bladder, 487–488

pancreas and duodenum, 488

Rewarming shock, 800

Rewarming techniques, 800

Reye’s syndrome

and NSAIDs, 301–302

Rh blood groups, 356, 357

See also Military transfusion practice; Transfusion therapy

Rhabdomyolysis, 725–726

See also Acute renal failure (ARF)

Rib fractures, 464

Richardson, Sir Benjamin, 857

Robert le Conquerant, 754

Robertson, Oswald H., 871

Robinul, 222

See also Glycopyrrolate

Roche Laboratories, 221

Roche Products, Inc., 221

Rocuronium bromide, 245

See also Nondepolarizing muscle relaxants

Rommel, Erwin, 3

Ropivacaine, 313

Roto-rest R, 413

Routh, G.S., 742

Rowbotham, Edgar Stanley, 873

Rule of Nines, 10, 96, 523

Russo-Japanese War, 865

Ruth, Henry Swartley, 874

Ryanodine, 823

Ryanodine-receptor gene, mutation

in malignant hyperthermia, 826

See also Genetic factors

S

Saline

See Hypertonic saline

Sams, Crawford F., 882
Anesthesia and Perioperative Care of the Combat Casualty

926

Shoemaker’s therapeutic goals, 651

Silent aspiration, 674

Silvadene, 37

Single twitch stimulation, 238, 240

Sinus evaluation

in sepsis/SIRS, 628

SIRS/MODS

See Systemic inflammatory response and multiple organ

dysfunction syndromes (SIRS/MODS)

Site of action

of general anesthetics, 193

Skin

and morphine, 296

and toxic injury, 840

See also Cutaneous side effects; Dermatological manifestations

Skull fracture

See Face and neck injuries

Sleep lag

See Fatigue and sleep lag

Slow, continuous ultrafiltration (SCUF), 735, 736

Small arms, 9–10

Small bowel

as injury site, 489–492

See also Intraperitoneal injuries

Snow, John, 860–861

Sodasorb, 158–159, 161, 162

Sodium, 567, 568, 570

Sodium channel

and local anesthetic receptor sites, 306

Sodium thiopental, 66

dose regimen, 215, 228

and shock, 878

used as total intravenous anesthetic, 230

after World War I, 873

during World War II, 877–878, 881

See also Thiopental

Somalia (Operation Restore Hope)

and aeromedical evacuation, 758

and blood banking, 365

and evacuation scheme, 45

and medical network, 44–45

and transfusion practice, 362

Somatic nerves

and regional anesthesia, 260

Somatosensory evoked potentials (SSEPs), 408

See also Evoked potentials

Soviet Union

and data from Medical Service of the Army, 57

“Space blanket,” 798

Spanish-American War, 865–866

Spanish Civil War

and evacuation, 754

Specialization, 874, 881–882

Specific-receptor theory

and local anesthetics, 305

Spinal anesthesia, 872

undesirability, 878

Spinal cord injury, 399–413

and anesthetic management, 407

and functional ability, 399

and initial care, 404–407

and management in intensive care unit, 407–412

and medical complications, 412–413

and physiological responses, 400–404

and protection, 408–411

and recommended modifications of ATLS, 37

See also Face and neck injuries; Neurological injuries

Sanofi Winthrop Pharmaceuticals, 124, 225

Schimmelbusch, Carl, 868

Schimmelbusch mask, 867, 868

Schoenfeld, P.Y., 721

Scipio, 752

Scopolamine, 222–223

clinical use and contraindications, 223

physiological effects, 222

Scott, Winfield, 860

Second-gas effect, 198, 201–202

Secondary closure, 506

Secondary hypothermia, 792

Secondary intention, 506

Seizure prophylaxis, 397

Seizure threshold

and benzodiazepines, 221

Seldinger technique, 324, 573–574

Selective Service Act of 1950, 884

Selenium, 572

Sellick’s maneuver, 46

Sensory evoked potentials, 112

See also Evoked potentials

Sepsis

and corticosteroid treatment, 642–643

definition, 598, 599, 615

etiology, 600

and extremity injuries, 505–506

and metabolic changes in response to stress, 557–558

severe, 599

See also Bacterial diseases; Metabolic derangements and

nutritional support; Systemic inflammatory response and

multiple organ dysfunction syndromes (SIRS/MODS);

Tropical diseases

Sepsis syndrome, 615

Septic shock, 598, 599, 615

See also Sepsis; Systemic inflammatory response and

multiple organ dysfunction syndromes (SIRS/MODS)

Serotonin, 290, 291, 293

Service-specific aspects of combat injury, 8

Servo 900C, 687

Severity of burns, 523

Sevoflurane, 194, 195, 198

See also Anesthetics; Inhalational anesthesia; Military

anesthesia machines

Shakespeare, William, 554

Sharpstone, P., 726

Shearing-Plough Health Care Products, Inc., 406

Shipway, Francis, 867–868

Shipway apparatus, 867–868, 869

Shivering, nonhypothermic, 800

Shock

and ARDS, 676

definition, 701

and extremity injuries, 504–505

and heart rate, 86

and nitrous oxide, 869

and recommended modifications of ATLS, 35–36

See also Hemorrhage, shock, and fluid resuscitation; Shock

therapy

Shock teams, 879

Shock therapy, 874

during World War I, 871–872

during World War II, 878–881

See also Military transfusion practice; Transfusion therapy

Shock Trauma Center, Maryland Institute for Emergency

Medical Services Systems (MIEMSS), 603

Shock wards, 879
927

Index

Spinal cord protection, 408–411

free radical scavengers, 410

glucocorticoids, 409–410

GM1 ganglioside, 410

hypothermia, topical, 409

opiate antagonists, 409

Spinal injuries

and recommended modifications of ATLS, 37

See also Cervical spine injuries; Face and neck injuries;

Spinal cord injury

Spinal shock, 444

and cardiovascular management, 411

Spirometry, 696

Spleen

as injury site, 493

See also Intraperitoneal injuries

Square-root-of-time kinetics, 183–184

Squibb, E.R., 863

SS Uganda, 756

Stabilization

and recommended modifications of ATLS, 37–38

and spinal cord injury, 404

Stadol, 227

See also Butorphanol

Staphylococcus aureus, 603, 622

See also Bacterial diseases; Systemic inflammatory

response and multiple organ dysfunction syndromes

(SIRS/MODS)

Starling’s equation, 83–84, 677

Starvation

and exercise and stress, 551–553

and metabolism, 549

See also Metabolic derangements and nutritional support

Stereoselectivity

in general anesthetics, 190

Steroids, 547

See also Metabolic derangements and nutritional support

Stomach

as injury site, 489–492

See also Abdominal injuries; Intraperitoneal injuries

Stone, W.J., 711

Stott, R.B., 742

Strategic evacuation system, 766–768

Stress

and starvation and exercise, 551–553

See also Metabolic derangements and nutritional support

Stress hormones

and sepsis/SIRS, 610

Stress-induced malignant hyperthermia, 814

Stress response, 253, 554–561

and blood flow changes, 557

immediate response, 554–557

metabolic changes in trauma with sepsis, 557–558

and organ bed changes, 557

and oxidative metabolic shifts, 558–559

patterns of, 563–564

and preferential amino acid utilization, 559–561

and protein turnover, 559–561

stages of, 554–561

See also Metabolic derangements and nutritional support

Stretchers

and air evacuation, 780

“floating,” 775

Structural specificity

lack of, in general anesthetics, 188–189

Stryker frames

and evacuation, 780, 782

Stuart Pharmaceuticals, 216

Sublimaze, 225

See also Fentanyl

Substance P, 290, 291, 293

Succinylcholine

breakdown, 236

with burn casualties, 534, 535–536

chloride, 242–243, 245

and ocular injuries, 74, 446

and thermal airway injury, 75

and thoracic casualties, 463

with unstable patients, 388

use during Korean War, 883

See also Anesthesia; Anesthetics

Sucking chest wound, 465

See also Chest injuries; Thoracic injuries

Sufenta, 226

See also Sufentanil

Sufentanil, 224, 226

as adjuvant to inhalational anesthesia, 229

Sulfa drugs, 881

See also Antibiotics

Sulfamylon, 37

Sun Medical, 72

Supportive care

of head injury casualties, 394–395

Supraorbital nerve compression, 432

Surface-charge theory

and local anesthetics, 305

Surgeon to Soldiers, 322

Surgery

for extremity injuries, 506

in immunocompromised patients with sepsis/SIRS, 620

positioning for, of casualties with abdominal injuries, 485

See also Abdominal trauma and war surgery; Management;

Neurosurgical intervention; Therapeutic measures;

Treatment

Surgical reexploration

and sepsis/SIRS/MODS, 628–629

Swann, R.C., 712, 742

“Swedish nose,” 781

Sympathetic nerves

and regional anesthesia, 260

Synaptic transmission, 193

Synchronized, intermittent, mandatory ventilation (SIMV),

688

Syringes, 863, 865

Systemic hypothermia, 787–804

cardiopulmonary resuscitation, 801–803

clinical and laboratory manifestations, 792–797

clinical prevention and treatment, 797–800

definition and classification, 792

effect of, on drug action, 803–804

and normal thermoregulation, 789–792

possible etiologies, 793

special concerns, 803

stages and characteristics, 795

See also Hypothermia; Temperature regulation

Systemic inflammatory response and multiple organ dysfunction syndromes (SIRS/MODS), 597–652

definition, 598, 599

diagnosis and monitoring, 623–629

epidemiology, 598–611

established multiple organ failure, 644–652

etiology, 600

organ-specific responses, 611–623

therapeutic modalities, 629–644
Anesthesia and Perioperative Care of the Combat Casualty

928

Systemic inflammatory response syndrome (SIRS)

See Systemic inflammatory response and multiple organ

dysfunction syndromes (SIRS/MODS)

T

T helper cells

and selenium deficiency, 572

See also Immunological aberrations

T-piece trials, 701–702

Tactical evacuation system, 763–766

Tartter, P., 334

Technidyne Corp, 106

Techniques for administering intravenous anesthetics, 227–230

as adjuvants to inhalational anesthesia, 228–229

as adjuvants for regional and local anesthesia, 229–230

rapid-sequence intravenous induction, 227–228

as total intravenous anesthesia, 229

Technological and logistical support, 44

TEMPER (tents, extendable, modular, personnel) tents, 126,

127, 129

Temperature measurement, 789

Temperature monitoring, 113

See also Hypothermia; Malignant hyperthermia; Thermal

regulation

Temperature regulation

in burn casualties, 536–537

normal, and systemic hypothermia, 789–792

See also Malignant hyperthermia; Systemic hypothermia

Tension pneumothorax, 69

See also Acute respiratory failure and ventilatory management

Teschan, P.E., 741–742, 743

Tetanic stimulation, 239, 240

Tetanus prophylaxis

with burn casualties, 525

Tetracaine, 312

Tetracaine hydrochloride, 878

Therapeutic cooling

and acid-base disturbances, 820

and hyperkalemia, 820

late complications, 820

masseter muscle rigidity, 820–821

Therapeutic measures, 92–95

hypothermia, 94

intraarterial infusion, 94

oxygen, supplemental, 93–94

patient position, 92–93

pneumatic antishock garment, 93

in thoracic trauma, 459

vasodilators, 95

vasopressors, 95, 635–636

See also Management; Prevention and treatment; Therapeutic modalities for sepsis/SIRS/MODS; Treatment

Therapeutic modalities for sepsis/SIRS/MODS, 629–644

antimicrobial therapy, 637–639

colloid solutions, 630–631

corticosteroids, 642–643

crystalloid solutions, 630

cyclooxygenase inhibitors, 643

fluid resuscitation, 629–631

immunotherapy, 641–642

inotropic and vasopressor drugs, 635–636

metabolic manipulations, 643–644

naloxone, 643

proposed therapies, 639–641

resuscitation fluid selection, 631–633

support of the respiratory system, 636–637

tissue oxygen delivery and consumption, 633–635

See also Management; Prevention and treatment; Therapeutic measures; Treatment

Thermal injuries, 96

and airway management, 75

and evacuation complications, 778

and resuscitating combat casualties, 96

See also Anesthesia for casualties of chemical warfare

agents; Burn injuries

Thermal stress

and biophysical effects, 774–775

Thermal trauma

and pulmonary insufficiency, 671–672

Thermoregulation

See Temperature regulation

Thiopental, 66

in the battlefield, 213

dose regimen, 215

See also Sodium thiopental

Thompson, Gale, 886

Thoracic injuries, 455–476

combat thoracic trauma: overview, 458–460

diagnosis and management of specific injuries, 464–475

etiology, 457

and evacuation complications, 777–778

management principles, 460–463

and recommended modifications of ATLS, 36

types of injury, 456–458

See also Airway management; Cardiovascular system;

Chest injuries; Thoracic surgery

Thoracic surgery

and applied anatomy for regional anesthesia, 260

and applied physiology for regional anesthesia, 260–261

and epidural anesthesia, 261, 262–263, 264

and intercostal nerve block, 261, 265–267

and interpleural nerve block, 261, 267

and peripheral nerve blocks, 261, 267

and regional anesthesia, 259–267

and spinal anesthesia, 261, 263–265

in World War I, 870

See also Thoracic injuries

Thoracoabdominal injury, 460

Thoracotomy, indications for, 460

Thrombocytopenia, dilutional

and platelet dyscrasia, 622–623

and platelets, 327–328

Thrombolic and embolic phenomena, 508–510

deep venous thrombosis and pulmonary embolism,

508–510

fat embolism syndrome, 510–513

Thrombosis, retinal artery, 432

Thromboxane A2

, 301, 383

and sepsis/SIRS/MODS, 608

Thyroxine-binding prealbumin

and nutritional repletion, 585

Tidal volume and respiratory rate, 690

Tissue oxygen delivery and consumption

and sepsis/SIRS/MODS, 633–635

Titanic, 790

To-and-Fro Absorber, 874

Total body surface area (TBSA), 523

See also Rule of Nines

Total intravenous anesthesia, 220–221, 229, 230

Total parenteral nutrition

and delivery, 572–575

and metabolic complications, 575, 576

and modifications, 575–578

Toxemic shock, 874
929

Index

Toxic agents

characteristics, 838–839

and complications of anesthesia, 846–847

and injury sites, 840–841

latency of onset, 838

spectrum of, 837–838

toxicity, 838

transmissibility, 839

Toxic injury

and anesthesia management, 841–846

Toxicity

of local anesthetics, 310–312

Trace elements, 571–572

chromium, 572

copper, 572

iron, 555, 571

manganese, 572

selenium, 572

zinc, 555, 571–572

Tracheal injuries, 472–473

and airway management, 74–75

diagnosis, 75

management, 75

See also Airway management; Face and neck injuries

Tracheal intubation, 447–448

See also Airway management; Face and neck injuries;

Intubation

Tracheostomies, 449

and aeromedical evacuation, 781

See also Airway management; Face and neck injuries

Traction

manual in-line axial traction (MIAT), 406

Train-of-four stimulation, 238–239, 240

Training

See Education of personnel

Transcapillary refill, 83

Transesophageal echocardiography, 109

Transferrin

and nutritional repletion, 584–585

Transfusion reactions

field management, 349–351

potential, 329–335

Transfusion support, 342, 351–354

effect of massive transfusion, 352

emergency collection and transfusion of whole blood

donated in field, 352–354

logistical aspects, 351–352

Transfusion therapy, 321–336

alternatives to volume replacement, 335–336

logistics, 322–325

potential adverse effects, 329–335

principles of good civilian practice, 336

purposes, 325–329

See also Military transfusion practice

“Transfusion trigger,” 326

Transmembrane pressure, 732

Transport

of burn casualties, 533

See also Evacuation; Military medical evacuation

Transtracheal jet ventilation, 448–449

Trauma

and immunosuppression, 619–620

with sepsis, and metabolic changes with stress, 557–558

See also Combat trauma overview; Metabolic derangements and nutritional support

Trauma Coma Data Bank, 383

Trauma-related sepsis and septic shock

and SIRS/MODS, 601–603

See also Trauma

Trauma Score, 25, 761–763

Traumatic brain injury

pathological anatomy and physiology, 382–386

patient care, 387–397

recovery and outcome, 398

See also Face and neck injuries; Neurological injuries

Traumatic injury

and SIRS/MODS, 601

Treatment

of ARDS, 678–680

of ARF, 726–731, 731–736, 736–741

of deep venous thrombosis and pulmonary embolism, 509–510

and DEPMEDS, briefs, 120–121

of established multiple organ failure, 651–652

of fat embolism syndrome, 512

of inhalation injury, 529

of oliguria, acute, 724

proposed, for sepsis/SIRS/MODS, 639–641

of shock, 871–872, 874, 878–881

of traumatic brain injury, 387–397, 398

See also Management; Prevention and treatment; Therapeutic measures

Trendelenburg’s position, 92–93

Treponema pallidum, 333

Tri-Service draw-over vaporizer, 165, 166–169

Triage

and casualty care decision tree, 34

categories, 38

after chemical attack, 843–844

and civil decision scheme, 765

Tropical diseases, 865

See also Bacterial diseases; Viral diseases

Trunkey, D.D., 16, 17

Tubular mechanisms

and ARF, 715

Tumble, of bullets, 10

and cavitation, 482

Tumor necrosis factor (TNF), 554, 555

and sepsis/SIRS/MODS, 607

See also Metabolic derangements and nutritional support

2-chloroprocaine, 312

U

U.S. Air Force patient classifications for aeromedical evacuation, 770

U.S. Army Burn Center, 672

U.S. Army Institute of Surgical Research Burn Unit, 535

U.S. Army Research Institute of Environmental Medicine

(USARIEM), 551

U.S. Army Surgical Research Laboratories, 871

U.S.N.S. Comfort (T-AH 20), 137

conversion, 756

in Haiti, 45

U.S.N.S. Mercy (T-AH 19), 137

conversion, 756

U.S. Naval Hospital (Brooklyn, NY), 863

USS Sanctuary, 711

Ulcers, decubitus

after spinal cord injury, 413

ULCO Field Anaesthesia Apparatus, 171–173

Ultrasonography

in sepsis/SIRS, 628

Uncertainty principle, pharmacological, 182

Unitary theory, 193

United States Pharmacopeia, 301

Univalent leak, 609
Anesthesia and Perioperative Care of the Combat Casualty

930

Univent-750, 687

Upjohn, 583

Uptake and distribution of inhalational anesthetics, 199–202

and biophysical properties, 199–201

factors affecting, 201–202

and minimal alveolar concentration (MAC), 202

Uremia

and bleeding disorders, 738–739

and dialysis, 738–739

and neurological abnormalities, 738

and pericarditis, 738

Ureters

as injury site, 487–488

See also Genitourinary system; Retroperitoneal injuries;

Urinary system

Urinary catheters

and evacuation, 780

Urinary system

and complications after spinal cord injury, 413

and morphine, 296

and regional anesthesia, 261

and secondary pain manifestations, 293–294

See also Genitourinary system; Ureters

V

Valium, 221

See also Diazepam

van’t Hoff’s law

inverse, 553

Vapor of Benzid, 861

Vaporizers, 165, 166–169

Vascular injuries, 487

and evacuation complications, 776, 778

with face and neck injuries, 442

See also Retroperitoneal injuries

Vascular mechanisms

and ARF, 715

Vasoactive agents

to prevent ARF, 722–723

Vasodilators, 95

Vasopressors, 95, 635–636

Vecuronium bromide, 243–244

See also Nondepolarizing muscle relaxants

Venous access, 87

gaining, 46

Venous pressure, central, 108–109

Ventilation

management of, after head injury, 396

management of, and recommended modifications of

ATLS, 35

mask, 447

transtracheal jet, 448–449

See also Mechanical ventilation; Oxygen and positivepressure ventilation; Pulmonary pathophysiology

Ventilators for combat use, 123, 702–704

and aeromedical evacuation, 781

and criteria for optimal use, 697

and examination of the patient-machine unit, 696

and functional design, 686–687

See also Equipment; Mechanical ventilation

Ventilatory failure

and diagnosing respiratory failure, 680, 681

and postoperative hypoxemia, 681–682

Venturi masks, 60

Verne, Jules, 754

Verni-Trol anesthetic vaporizer-flow calculator, 156, 157

Versed, 221

See also Midazolam

Vertebral injuries, 443

See also Cervical spine injuries

Very rapid hypothermia, 792

Vesicants, 673

See also Blister agents

Vessels, great

as injury site, 487

See also Retroperitoneal injuries

Vibration

See Noise and vibration

Vietnam Head Injury Study, 380

Vietnam Vascular Registry, 487

Vietnam War

and abdominal trauma, 480

and aeromedical evacuation, 758, 776

and ARF, 711–712

and blood transfusion, 323, 346, 357, 483

and mechanical ventilation, 685–686

and military anesthesia, 885–892

and morbidity, 23

and mortality, 14, 15, 16, 480

and MUST hospitals, 118–119

and regional anesthesia, 887–888

Viral diseases, 331–332

cytomegalovirus (CMV), 333

Epstein-Barr virus, 333

and evacuation complications, 778

hepatitis, 331–332

human immunodeficiency virus (HIV), 331, 332–333

and therapeutic modalities, 639

See also Infectious diseases

Viscera

and toxic injury, 840

Viscous injury, 458

Vitamins, 572

requirement, 573

Volatile anesthetics, potent

See Potent volatile anesthetics

Volume expansion

and ARF, 721

See also Hypovolemia

Volume overload

and dialysis, 737

Volume replacement

alternatives, 335–336

See also Hypovolemia

Volume resuscitation, 879–880

See also Fluid resuscitation; Hypovolemia; Resuscitation;

Resuscitation fluid selection; Transfusion therapy

W

Walter Reed Army Medical Center, 889

War

American Civil War, 862–863

Boer War, 865

Crimean War, 861

Falklands War, 755–756

Franco-Prussian War, 754

Iran-Iraq War, 458

Korean War, 882–884

Mexican War, 860–862

and mortality, from 1854 through 1989, 18–19

Persian Gulf War, 132–134, 143, 152, 157, 166

Punic War, Second, 752
931

Index

Russo-Japanese War, 865

Spanish-American War, 865–866

Spanish Civil War, 754

Vietnam War, 885–892

World War I, 866–872

World War II, 874–882

See also individual entries

Warming

estimated sources, 799

supplemental, devices, 798–799

Washington, George, 788

Waters, Ralph, 874

Weaning from ventilation, 699–702

criteria for, 412, 699

decision tree, 700

definition, 699

Weapons, 8–10

Wellington (Duke of), Arthur Wellesley, 753

Wells, Horace, 857

Westermark’s sign, 698

Whipple procedure, 488

Whole blood, 880, 881

vs component therapy, blood, 324–325

transfused from field donation, 352–354

See also Military transfusion practice; Transfusion

therapy

Williams intubating airway, 72

Winnie 3-in-1 paravascular approach, 276, 277

Women

and anesthesia, 862

as nurses, 865, 867

and Rh blood groups, 356, 357

as surgeons, 865

during World War I, 867

See also Personnel

Wood, Alexander, 865

World War I

and blood transfusions, 871–872

and chemical warfare, 835, 840

and chest surgery, 870

and mortality, 15

World War II

and aeromedical evacuation, 754, 755, 758

and anesthetics, 875–878

and ARF, 710–711

and asphyxiation, 57

and attrition, 3–4

and burn injuries, 522

and equipment, 875–878

and mobile hospitals, 116

and mortality, 15–16, 24, 480

and pain study, 288

and personnel, 874–875

and regional anesthesia, 878

and transfusion practice, 322, 345, 355, 357, 361

Wound ballistics

in abdominal trauma, 481–482

See also Munitions, explosive

Wound care

of burn injuries, 526

Wound Data and Munitions Effectiveness Team (WDMET)

study, 11–13, 29–30, 40 n.15, 56, 76 n.3, 283 n.1, 415 n.3, 496

n.38, 516 n.6, 553, 705 n.1

Wound depth, 11–13

X

Xenophon, 788

Y

Yaw, of bullets, 457

and cavitation, 482

and tumble, 10

and wound damage, 378

Yersinia enterocolitica, 333

Yom Kippur War

and abdominal casualties, 480

Z

Zieve’s syndrome, 564

Zinc, 555, 571–572

Zone of the interior, 763–768

Zygomatic fractures, 441