The December 2015 ASA Monitor features an article written by Uday Jain, M.D., which discusses the problem of anesthesia in disaster or an austere environment. Disasters can produce multiple trauma victims, all of whom may be problematic to anesthesiologists who work to ensure these patients’ survival.

In the article, Dr. Jain mentions essential supplies and equipment, and discusses the proper use of anesthetic agents and analgesics, as well as different anesthetic techniques (i.e., general versus regional). Dr. Jain states that ketamine can be given to relieve pain. Many anesthesiologists administer ketamine in trauma and disaster patients because of its ability to maintain hemodynamic stability. However, many anesthesiologists may not realize that ketamine can work in the opposite fashion and endanger patients. We wish to point out the downside that ketamine poses in disaster and trauma patients.

It is...

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