Multiple casualty terror events: the anesthesiologist's perspective.

Abstract:

UNLABELLED:In a 28-mo period 14 multiple-casualty terror events occurred in Jerusalem, challenging the Department of Anesthesiology and Critical Care Medicine of the city's sole Level 1 trauma center. We performed a retrospective review of the response of the department to evaluate staff activities, resource use (emergency department, operating rooms, and intensive care unit [ICU]), and patient flow. A total of 1062 people were injured in the 14 multi-casualty terror incidents. The emergency department treated 355 victims; 108 of them were hospitalized, and 58 underwent surgery during the first 8 h. Only two surgeries were performed during the first hour, and the average time to the first surgery was 124 min. Fifty-one patients were admitted to the ICU an average of 5.5 h after the terror event. After a terrorist act, multiple, simultaneous efforts were required of the anesthesiology department, including taking part in the initial resuscitation in the emergency department, anesthetizing victims for surgery and angiographies, and caring for them in the recovery room and ICU. Therefore, anesthesiology departments are greatly impacted by such events and must plan for them to maximize the use of available personnel and to have the appropriate equipment and supplies available. IMPLICATIONS:Anesthesiologists provide essential care to patients injured in terror events, from the initial resuscitation through therapeutic/diagnostic procedures and surgeries. Operational issues faced by a department of anesthesiology during the initial 8 h after terrorist actions were examined. Multiple, and often parallel, efforts were required of the department.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Shamir MY,Weiss YG,Willner D,Mintz Y,Bloom AI,Weiss Y,Sprung CL,Weissman C

doi

10.1213/01.ane.0000121307.33776.84

subject

Has Abstract

pub_date

2004-06-01 00:00:00

pages

1746-52, table of contents

issue

6

eissn

0003-2999

issn

1526-7598

journal_volume

98

pub_type

杂志文章
  • Increases in spinal cerebrospinal fluid potassium concentration do not increase isoflurane minimum alveolar concentration in rats.

    abstract:BACKGROUND:Previous studies demonstrated that MAC for isoflurane directly correlates with the concentration of Na(+) in cerebrospinal fluid surrounding the spinal cord, the primary site for mediation of the immobility produced by inhaled anesthetics. If this correlation resulted from increased irritability of the cord,...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181815f2b

    authors: Shnayderman D,Laster MJ,Eger EI 2nd,Oh I,Zhang Y,Jinks SL,Antognini JF,Raines DE

    更新日期:2008-09-01 00:00:00

  • Catheter-associated masses in patients receiving intrathecal analgesic therapy.

    abstract:UNLABELLED:A cohort of seven patients receiving intrathecal analgesic drug therapy for chronic intractable pain underwent radiocontrast myelography and computed tomography (CT) scanning to screen for catheter-associated intrathecal masses. Three of seven patients examined had intraspinal masses associated with the tip ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200301000-00039

    authors: McMillan MR,Doud T,Nugent W

    更新日期:2003-01-01 00:00:00

  • The effect of universal leukodepletion of packed red blood cells on postoperative infections in high-risk patients undergoing abdominal aortic surgery.

    abstract:UNLABELLED:We evaluated, by using a before-and-after study, the influence of leukoreduction by filtration on postoperative infections and adverse outcomes in patients undergoing elective major aortic surgery. From January 1995 to October 2000, all patients who underwent elective abdominal aortic surgery were included i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200203000-00010

    authors: Baron JF,Gourdin M,Bertrand M,Mercadier A,Delort J,Kieffer E,Coriat P

    更新日期:2002-03-01 00:00:00

  • The effectiveness of a simple novel approach on electroencephalograph instruction for anesthesiology residents.

    abstract:BACKGROUND:The electroencephalogram (EEG) measures cerebral activity and, because of its use as an intraoperative monitor, the Accreditation Council for Graduate Medical Education requires EEG monitoring experience during anesthesiology residency. To improve the anesthesiology residents' education at the University of ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000287666.72775.07

    authors: Fahy BG,Chau DF,Owen MB

    更新日期:2008-01-01 00:00:00

  • The utility of tracheal temperature monitoring.

    abstract::Tracheal temperature--the temperature of the tracheal wall--is believed to reflect the core temperature. The trachea reacts quickly to temperature changes because it is surrounded by various large arteries and veins. Using the blood temperature from the cardiopulmonary bypass (CPB) and the jugular vein temperature as ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/00000539-199304000-00020

    authors: Yamakage M,Kawana S,Watanabe H,Namiki A

    更新日期:1993-04-01 00:00:00

  • An Evaluation of Ultrasound-Guided Adductor Canal Blockade for Postoperative Analgesia After Medial Unicondylar Knee Arthroplasty.

    abstract:BACKGROUND:Unicondylar knee arthroplasty (UKA) is a commonly performed procedure with significant expected postoperative pain. Peripheral nerve blocks are 1 analgesic option, but some approaches may decrease quadriceps motor strength and interfere with early ambulation. In this study, we compared the analgesia provided...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000001162

    authors: Henshaw DS,Jaffe JD,Reynolds JW,Dobson S,Russell GB,Weller RS

    更新日期:2016-04-01 00:00:00

  • The effect of dexmedetomidine on perioperative hemodynamics in patients undergoing craniotomy.

    abstract:BACKGROUND:The perioperative course of patients undergoing intracranial surgery is frequently complicated by hypertensive episodes. Dexmedetomidine (DEX), an alpha-2 adrenoreceptor agonist, is gaining popularity in neuroanesthesia, because its sympatholytic and antinociceptive properties may improve hemodynamic stabili...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ane.0b013e3181804298

    authors: Bekker A,Sturaitis M,Bloom M,Moric M,Golfinos J,Parker E,Babu R,Pitti A

    更新日期:2008-10-01 00:00:00

  • The Effect of Intrathecal Morphine Dose on Outcomes After Elective Cesarean Delivery: A Meta-Analysis.

    abstract:BACKGROUND:The intrathecal morphine dose achieving optimal analgesia for cesarean delivery while minimizing side effects has not yet been deduced. In this meta-analysis, our objective was to determine whether low- or high-dose intrathecal morphine provides acceptable duration and intensity of analgesia with fewer side ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,meta分析,评审

    doi:10.1213/ANE.0000000000001255

    authors: Sultan P,Halpern SH,Pushpanathan E,Patel S,Carvalho B

    更新日期:2016-07-01 00:00:00

  • Comparison of resuscitation of sheep and dogs after bupivacaine-induced cardiovascular collapse.

    abstract::This study evaluated interspecies sensitivity and ability to resuscitate pentobarbital anesthetized sheep and dogs after cardiovascular toxic doses of bupivacaine. Every minute, 3 mg/kg of bupivacaine was injected into the right atrium over the course of 10 sec until cardiovascular collapse occurred. While the bupivac...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Kasten GW,Martin ST

    更新日期:1986-10-01 00:00:00

  • Myocardial metabolism and hemodynamic responses with isoflurane anesthesia for coronary arterial surgery.

    abstract::Isoflurane-oxygen was given for induction and maintenance of anesthesia to ten patients having coronary artery bypass grafts. All had preserved ventricular function without hypertension or other cardiac lesions; treatment with beta-blocking drugs was maintained until the operation in all patients. Cardiac output, arte...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Moffitt EA,Barker RA,Glenn JJ,Imrie DD,DelCampo C,Landymore RW,Kinley CE,Murphy DA

    更新日期:1986-01-01 00:00:00

  • The urodynamic effects of intravenous opioids and ketoprofen in humans.

    abstract:UNLABELLED:We used a double-blind design to study urodynamic changes induced by mu-agonists (fentanyl, morphine), a partial mu-agonist antagonist (buprenorphine), a putative mu-antagonist, kappa-agonist (nalbuphine), and ketoprofen, an injectable nonsteroidal antiinflammatory drug. Men (20-55 yr old) were randomly assi...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199808000-00042

    authors: Malinovsky JM,Le Normand L,Lepage JY,Malinge M,Cozian A,Pinaud M,Buzelin JM

    更新日期:1998-08-01 00:00:00

  • Hemodynamic effects of dobutamine in patients following mitral valve replacement.

    abstract::Mitral valve replacement is frequently complicated by a low cardiac output syndrome and elevated pulmonary arterial pressures. In the present study, we used dobutamine to increase cardiac index and measured the pulmonary hemodynamic effects in 10 patients with increased pulmonary vascular tone following mitral valve r...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Schwenzer KJ,Miller ED Jr

    更新日期:1989-04-01 00:00:00

  • The Wood Library-Museum's 1858 edition of John Snow's On chloroform and other anaesthetics.

    abstract::The original 1858 edition of John Snow's On Chloroform and Other Anaesthetics, from which came the Wood Library-Museum of Anesthesiology reprints in 1971 and 1989, was donated to the Wood Library-Museum by Ralph Waters of Madison, Wisconsin, in 1967. The book contains a message of appreciation to Waters, dated October...

    journal_title:Anesthesia and analgesia

    pub_type: 历史文章,杂志文章

    doi:10.1213/00000539-199009000-00013

    authors: Maltby JR,Bamforth BJ

    更新日期:1990-09-01 00:00:00

  • The effects of olprinone (a phosphodiesterase III inhibitor) on hepatic vascular bed in a porcine model of endotoxemia.

    abstract:UNLABELLED:Decreased hepatic blood flow, and impaired hepatic oxygen delivery caused by endotoxin, result in hepatic metabolic deterioration followed by liver dysfunction and multiple organ failure. Among phosphodiesterase III inhibitors, only olprinone increases hepatosplanchnic blood flow. We evaluated the effects of...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200103000-00024

    authors: Nagata E,Kakihana Y,Tobo K,Isowaki S,Kanmura Y

    更新日期:2001-03-01 00:00:00

  • The anxiolytic effects of the 5-hydroxytryptamine-1A agonist tandospirone before otolaryngologic surgery.

    abstract:UNLABELLED:We studied 160 ASA I or II patients undergoing elective otolaryngologic surgery in order to compare the anxiolytic effects of a novel 5-hydroxytryptamine-1A agonist, tandospirone, with diazepam. To monitor preoperative anxiety, the following variables were used: systolic and diastolic arterial pressure, hear...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200111000-00034

    authors: Oshima T,Kasuya Y,Terazawa E,Nagase K,Saitoh Y,Dohi S

    更新日期:2001-11-01 00:00:00

  • The effect of ketamine or thiamylal on succinylcholine-induced myoglobinemia under halothane anesthesia in adults.

    abstract::We studied the effect of intravenous (IV) thiamylal or ketamine on the increases in serum myoglobin, creatine kinase (CK), and potassium induced by succinylcholine under halothane anesthesia. Ninety patients were divided into three groups. In Group O, succinylcholine (1.0 mg/kg) was administered after an the inhaled i...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199511000-00021

    authors: Noguchi I,Sankawa H,Andou M

    更新日期:1995-11-01 00:00:00

  • Plasma potentiates the priming effects of endotoxin on platelet activating factor-induced pulmonary hypertension in the rabbit lung.

    abstract::During Gram-negative sepsis, endotoxin lipopolysaccharide (LPS) may activate host inflammatory responses, resulting in the systemic inflammatory response syndrome and the adult respiratory distress syndrome. In cell culture systems, LPS activation of cellular responses may be potentiated by plasma proteins. In the iso...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199608000-00008

    authors: Goldsmith JA,Kavanagh BP,Pearl RG

    更新日期:1996-08-01 00:00:00

  • The use and effectiveness of electrocardiographic telemetry monitoring in a community hospital general care setting.

    abstract:UNLABELLED:The purpose of this study was to determine if rates of telemetry events differ between patients whose monitoring is appropriately "indicated" versus "not indicated" by systematically applying rigorous criteria for appropriateness of electrocardiogram (ECG) telemetry usage. We performed a retrospective cohort...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/01.ane.0000081720.49358.53

    authors: Curry JP,Hanson CW 3rd,Russell MW,Hanna C,Devine G,Ochroch EA

    更新日期:2003-11-01 00:00:00

  • Gabapentin enhances the analgesic effect of morphine in healthy volunteers.

    abstract:UNLABELLED:The most effective group of drugs for the treatment of severe pain is opioid analgesics. Their use, however, is limited by decreased effects in neuropathic and chronic pain as a result of increased pain and development of tolerance. Gabapentin (GBP) is effective in both experimental models of chronic pain an...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200007000-00035

    authors: Eckhardt K,Ammon S,Hofmann U,Riebe A,Gugeler N,Mikus G

    更新日期:2000-07-01 00:00:00

  • Orthostatic hypotension during postoperative continuous thoracic epidural bupivacaine-morphine in patients undergoing abdominal surgery.

    abstract::Fifty patients undergoing colonic surgery received combined thoracic epidural and general anesthesia followed by continuous epidural bupivacaine 0.25% and morphine 0.05 mg/mL, 4 mL/h, for 96 h postoperatively plus oral tenoxicam 20 mg daily. Heart rate (HR) and arterial blood pressure (BP) were measured at supine rest...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199611000-00022

    authors: Crawford ME,Møiniche S,Orbaek J,Bjerrum H,Kehlet H

    更新日期:1996-11-01 00:00:00

  • Operating room managerial decision-making on the day of surgery with and without computer recommendations and status displays.

    abstract:BACKGROUND:There are three basic types of decision aids to facilitate operating room (OR) management decision-making on the day of surgery. Decision makers can rely on passive status displays (e.g., big screens or whiteboards), active status displays (e.g., text pager notification), and/or command displays (e.g., text ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000268539.85847.c9

    authors: Dexter F,Willemsen-Dunlap A,Lee JD

    更新日期:2007-08-01 00:00:00

  • Preoperative gabapentin: the effect on ropivacaine subarachnoid block and hemodynamics.

    abstract:BACKGROUND:Gabapentin is an adjuvant analgesic and may enhance the spread of subarachnoid block. We investigated the effects of pretreatment with gabapentin on subarachnoid block characteristics and hemodynamics. METHODS:Seventy patients undergoing transurethral procedures under subarachnoid anesthesia with 2.2 mL of ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/01.ane.0000295786.66822.60

    authors: Fassoulaki A,Chatziara V,Melemeni A,Zotou M,Sarantopoulos C

    更新日期:2008-01-01 00:00:00

  • Antiemetics of the 5-hydroxytryptamine 3A antagonist class inhibit muscle nicotinic acetylcholine receptors.

    abstract::Antagonists of the serotonergic 5-hydroxytryptamine 3A receptor (5-HT(3A)R) and muscle nicotinic acetylcholine receptors (nAChR) are widely used in anesthesia practice. Both 5-HT(3A)R and nAChR are ligand-gated ion channels with known pharmacological overlap between some of their agonists and antagonists. We studied t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000160531.65953.77

    authors: Paul M,Callahan R,Au J,Kindler CH,Yost CS

    更新日期:2005-09-01 00:00:00

  • Ultrasound-guided peripheral nerve stimulator placement in two soldiers with acute battlefield neuropathic pain.

    abstract::Acute peripheral neuropathic pain after combat-related polytrauma is a common occurrence in the United States military that is often refractory to current drugs and regional anesthesia. Both spinal cord and peripheral nerve stimulation are successfully used for chronic neuropathic pain states, but are not reported for...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e318247f6b2

    authors: Kent M,Upp J,Spevak C,Shannon C,Buckenmaier C 3rd

    更新日期:2012-04-01 00:00:00

  • How to schedule elective surgical cases into specific operating rooms to maximize the efficiency of use of operating room time.

    abstract:UNLABELLED:We considered elective case scheduling at hospitals and surgical centers at which surgeons and patients choose the day of surgery, cases are not turned away, and anesthesia and nursing staffing are adjusted to maximize the efficiency of use of operating room (OR) time. We investigated scheduling a new case i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200204000-00030

    authors: Dexter F,Traub RD

    更新日期:2002-04-01 00:00:00

  • Kinetics of anesthetic onset measured with a direct index of neural activity.

    abstract:BACKGROUND:Previous modeling of the kinetics of uptake and elimination of anesthetic drugs from the site of action has used measures derived from the electroencephalogram. Such measures lag the current brain activity because of the time needed to acquire a signal sample and derive the measure. With a direct measure of ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3182549490

    authors: Drummond GB,Bleach L,Thomson AJ,Kennedy RR

    更新日期:2012-09-01 00:00:00

  • Bradykinin antagonists have no analgesic effect on incisional pain.

    abstract::Bradykinin, an endogenous nonapeptide and an important mediator of inflammation, is also implicated in the initiation and maintenance of pain. Both des-Arg(8), Leu(8)-bradykinin (dALBK) and HOE-140, the prototypic bradykinin B1 and B2 receptor antagonists, respectively, have been shown to reduce pain behaviors and inf...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000130348.85587.BE

    authors: Leonard PA,Arunkumar R,Brennan TJ

    更新日期:2004-10-01 00:00:00

  • Effects of fentanyl, naloxone, and clonidine on hemodynamics and plasma catecholamine levels in dogs.

    abstract::A 50-micrograms/kg dose of fentanyl, given intravenously in divided doses to dogs under enflurane-nitrous oxide anesthesia caused sharp decreases in heart rate (HR), arterial blood pressure (AP), left ventricular dP/dt, and plasma levels of catecholamines. Naloxone, 20 micrograms/kg given 65-70 min later, completely a...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Flacke JW,Flacke WE,Bloor BC,Olewine S

    更新日期:1983-03-01 00:00:00

  • Postoperative Cognitive Dysfunction and the Change of Regional Cerebral Oxygen Saturation in Elderly Patients Undergoing Spinal Surgery.

    abstract:BACKGROUND:In this study, we examined the relationship between postoperative cognitive dysfunction (POCD) and intraoperative regional cerebral oxygen saturation (rSO2) in elderly patients undergoing spinal surgery. METHODS:We enrolled 87 patients older than 65 years. All patients were tested using a battery of cogniti...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000001352

    authors: Kim J,Shim JK,Song JW,Kim EK,Kwak YL

    更新日期:2016-08-01 00:00:00

  • The pharmacodynamic effects of a lower-lipid emulsion of propofol: a comparison with the standard propofol emulsion.

    abstract:UNLABELLED:Using a randomized, double-blind protocol design, we compared a new lower-lipid emulsion of propofol (Ampofol) containing propofol 1%, soybean oil 5%, and egg lecithin 0.6% with the most commonly used formulation of propofol (Diprivan) with respect to onset of action and recovery profiles, as well as intraop...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ane.0000103184.36451.d7

    authors: Song D,Hamza M,White PF,Klein K,Recart A,Khodaparast O

    更新日期:2004-03-01 00:00:00