Sunday, October 17, 2010

Battlefield Anesthesia Delivery

COL Bill Giles, CRNA
I have just received notification that several anesthesia students have become followers of this blog.  For their education and enjoyment, this blog is for you.  As for the rest of you, bear with me.

The Ohmeda Drawover Vaporizer
The traditional device for anesthesia delivery in the FST has been the drawover vaporizer.  It requires no power, and is extremely portable.  It can be used to deliver any inhalation agent available today with the exception of desflurane.  Patients may be spontaneously breathing or controlled.  There is no rebreathing; every breath gets fresh gas.  Therefore, there is no CO2 absorption.  As you can well imagine, you go through quite a bit of agent, and quickly!  The advantage of this device is that changes in anesthetic depth can take effect much more rapidly than in a semi-closed or closed system.

Draager Narcomed M Anesthesia Machine
Our FST is fortunate enough to have a Draager field anesthesia machine.  This platform delivers anesthetic gases much as any machine used stateside.  It is compact and relatively portable.  We have no agent analysis in the field, but we can monitor ETCO2 via a Propaq monitor.  We use this machine as our primary device, with the drawover for our second OR bed.  As always, TIVA is an available option in our anesthesia armamentarium.

Of interest to the CRNA students is that in the TO&E (table of organization and equipment) of an FST, the only anesthesia providers listed are 2 CRNAs.  An MDA can only work in an FST if he/she volunteers to fill a CRNA slot, and has approved orders.  The US military recognizes quality, cost-effective anesthesia care for its heroes!

The views of this blog are those of the author only, and not necessarily of the US Army or the US Government.  None of the information given is classified in nature.


  1. Thanks Bill for posting this! Please be safe, you are always in my prayers. Thank you for what you do!
    Colleen Bailey, SRNA CMC-NAP

  2. Bill, these are great photos. Thanks for the description of the drawover vaporizer.

  3. Hi Bill,
    Thanks so much for all of your posts, especially the pictures and descriptions of what kind of equipment you have to work with. I've always wondered what field anesthesia is like and will be following your blog with great interest. Thank you for your service and taking the extra time to blog and share your thoughts and experiences with others back home.

    Ann Marie Poli, RN, SRNA Duke University

  4. Thanks for the peek into the world of field anesthesia...I am really looking forward to following your blog! Thank you for all you will be in my thoughts and prayers.

    Shannon K. Morgan, SRNA Duke University

  5. Hello Bill,

    What an amazing window into the world of anesthesia in the military! I do have a question (which will expose my ignorance about the military).... what is "FST"?

    Thanks for creating this blog. I'm sure we all have a lot to learn from what happens on the battlefield front!

    Lori Bizzell, SRNA Duke University

  6. My brother is an Air Force officer and my Dad is a CRNA so I greatly appreciate all that you do! Thanks for taking the time to open your world to us. Do you happen to know what the age limit is to join the military as a CRNA and attend officer training school? Thank you.
    Kirsten Thulin, SRNA Duke University

  7. Bill, you are an amazing mentor, those youngsters are so fortunate to have you by their side.

  8. Col. Giles,
    Thank you for this blog. This is great. I am a classmate of addriane's @ CMC/NAP. I did 6 yrs in the reserves as an apache mech. I am truly interested in joining the military again once I finished school. I am trying to get my wife onboard. I hope all is well and you and all the soldiers there come back home safe. Tke care and keep us all here state side up to date as you can. Once again thank you. Juan Ortiz SRNA CMC/NAP Charlotte, NC

  9. Col. Giles,

    Thank you for sharing this blog! The pictures are great, it's awesome to see what you guys do over there. Thank you for your service and keeping our country safe!
    Phillip Merritt, SRNA Duke University

  10. Thanks for sharing this blog and for your service to our country!

    Chris Thomas SRNA, Duke University

  11. Lori,

    FST = Forward surgical team ;
    staffed by CRNAs