Safe and effective response to blast injuries is enhanced by an understanding of the physics and applied pathophysiology of these events. The mechanisms of injury are presented, along with an interpretation of the clinical implications in the tactical environment.

This chapter describes the safe conduct of general anaesthesia. Topics covered include induction of anaesthesia; maintenance of anaesthesia; total intravenous anaesthesia; and volatile anaesthetic agents. The important methods of monitoring the patient are discussed in detail, including monitoring of neuromuscular blockade, depth of anaesthesia and cardiac output. The measurement and control of patient temperature is described. The common surgical positions are described, together with their safety concerns. The chapter finishes with a discussion of the prevention and treatment of postoperative nausea and vomiting.

This chapter describes the blood products which are commonly required as part of anaesthetic practice, including red cells, plasma, cryoprecipitate, platelet concentrate, and concentrated coagulation factor preparations. The essential components of patient blood management, aiming to reduce the requirement for transfusion, are described. The principles and practice of massive blood transfusion are described. The specific management of Jehovah’s Witnesses, and other patients who decline blood transfusion, is discussed. The chapter finishes with a discussion of the common intravenous fluid preparations which are used in practice, and how to use them appropriately.