MILITANCY TRAUMA : ANAESTHESIA AND CRITICAL CARE MANAGEMENT.

At a Base Hospital, 2151 patients of militancy trauma were managed from Jan 1990 to 31 May 1993. It involved military, paramilitary, ex-servicemen, civilians, foreigners and antinational elements. The nature of trauma was either gun shot wounds (1333) or blast injuries (818). Polytrauma (multiple injury to soft tissue, hone, parenchyma with shock or injury to more than one body region) was seen in 862 patients. Standard protocol was evolved for initial management in ICU/acute surgical ward. Time taken for initial evaluation of injury, resuscitation, respiratory care and oxygen therapy, analgesics, blood group cross matching, antibiotics and preparation of the part before surgery was usually 45 min. Anaesthesia was induced with ketamine 2 mg/kg or thiopentone 3 mg/kg based on haemodynaemic response and maintained with N2O : O2 (50 : 50 ratio), relaxant controlled ventilation. Mortality was 3.8% including 4 deaths on operation table.