1. Joint Special Operations Medical Training Center Administer Parenteral General Anesthesia 081-833-4548 INSTRUCTOR SFC HILL

2. Joint Special Operations Medical Training Center OBJECTIVE As a Special Forces Medic given a patient requiring general parenteral anesthesia in a fixed or temporary facility, induce the patient to stage three of general anesthesia in accordance with JSOMTC student manual of anesthesia.

3. Joint Special Operations Medical Training Center REASON As a Special Forces Medic you must be prepared to anesthetize a patient requiring invasive procedures.

4. Joint Special Operations Medical Training Center PROCEDURES Insure anesthetist preparation Insure patient preparation Induce parenteral general anesthesia Emergency induction of parenteral general anesthesia

5. Joint Special Operations Medical Training Center Insure anesthetist preparation Inspect the anesthetist cart insure presents of anaphylaxis kit insure presents of SPARKS kit Insure the proper drugs are present in sufficient amounts and not out of date

6. Joint Special Operations Medical Training Center Insure anesthetist preparation Insure pharyngeal suction apparatus are operational and manual backup suction is present Switch on, set up and calibrate all monitors Clearly label all syringes with the appropriate agent and amount in milligrams Check all endotracheal equipment

7. Joint Special Operations Medical Training Center Insure patient preparation Review preanesthetic visit (SF517) When the patient arrives, verify identity, and the nature and site of the scheduled operation Establish rapport with the patient

8. Joint Special Operations Medical Training Center Insure patient preparation Insure a base line set of vitals has been established Insure established IV is patent Attach all monitoring devices Insure the patient has received the proper preanesthetic medication (five rights)

9. Joint Special Operations Medical Training Center Induce Parenteral general anesthesia Start induction 30 minutes after last premedication was given

10. Joint Special Operations Medical Training Center Induce Parenteral general anesthesia Muscle relaxation Diazepam (induction) 0.3 - 0.5 mg/kg Slow IV push

11. Joint Special Operations Medical Training Center REMEMBER! COMPONENTS OF GENERAL ANESTHESIA 1. Unconsciousness (Hypnosis) 2. Analgesia (Areflexia) 3. Muscle relaxation

12. Joint Special Operations Medical Training Center Induce Parenteral general anesthesia Unconsciousness Ketamine (induction) 1 - 2 mg/kg slow IV push

13. Joint Special Operations Medical Training Center Induce Parenteral general anesthesia On completion of induction, a rapid sequence intubation should be preformed to protect the patients airway The patient should then be placed on anesthesia maintenance

14. Joint Special Operations Medical Training Center Emergency induction of parenteral general anesthesia

15. Joint Special Operations Medical Training Center Emergency induction of parenteral general anesthesia Emergency patients should be stabilized prior to induction of anesthesia whenever possible With the unstable patient, induction should proceed when only the immediate surgical intervention will save the patients life

16. Joint Special Operations Medical Training Center Induce Parenteral general anesthesia Muscle relaxation Diazepam (induction) 0.3 - 0.5 mg/kg Slow IV push

17. Joint Special Operations Medical Training Center Induce Parenteral general anesthesia Unconsciousness Ketamine (induction) 1 - 2 mg/kg slow IV push

18. Joint Special Operations Medical Training Center Induce Parenteral general anesthesia On completion of induction, a rapid sequence intubation should be preformed to protect the patients airway The patient should then be placed on anesthesia maintenance

19. Joint Special Operations Medical Training Center SUMMARY OF PROCEDURES Insure anesthetist preparation Insure patient preparation Induce parenteral general anesthesia Emergency induction of parenteral general anesthesia

20. Joint Special Operations Medical Training Center RESTATED OBJECTIVE As a Special Forces Medic given a patient requiring general parenteral anesthesia in a fixed or temporary facility, induce the patient to stage three of general anesthesia in accordance with JSOMTC student manual of anesthesia.