Anaesthesia in a Disaster Zone: A Report on the Experience of an Australian Medical Team in Banda Aceh following the ‘Boxing Day Tsunami’

Abstract

We report on the experience of a 23-member Australian medical team in Banda Aceh, Indonesia, following the 2004 Boxing Day tsunami. Arriving 13 days after the tsunami that devastated the city, killed 100,000 of its inhabitants and injured thousands more, we carried out 130 surgical procedures in austere conditions over a 12-day period. Most surgery was peripheral, principally for plastic surgical or orthopaedic procedures to lower limb injuries. Intravenous ketamine anaesthesia was the technique of choice, with good surgical conditions and few significant side-effects.

The 2009 Samoan Tsunami – the Victorian disaster medical assistance team deployment

“…There were a small number of fractures, predominantly of the femur, which were treated with tibial traction. The injury patterns were similar to those recorded in the Banda Aceh tsunami, to which Australia also responded 2,3 …”

Ketamine: Use in Anesthesia

“…Disaster medicine represents an area where the ideal qualities of ketamine as a prehospital agent are at the fore, and it has therefore been widely used as a field anesthetic in austere conditions. Experience from Banda Aceh [58], Kashmir [59], and Haiti [60] demonstrates its usefulness. Where possible, it is appealing to supplement ketamine anesthesia with regional anesthesia where there is a paucity of equipment.…”

Involvement of ATP‐sensitive K+ channels in the peripheral antinociceptive effect induced by ketamine

“…Ketamine has been extensively used in human and veterinary clinical practice as an analgesic and dissociative anesthetic (Reich & Silva ; Paix et al. ; Sinner & Graf ). In addition, ketamine has been described for treatment of acute, chronic (Elia & Tramer ; Bell ) and burn injury pain (White et al.…”