Damage control anesthesia

The role of the anesthesiologist in damage control trauma care is that of resuscitation consultant. Damage control anesthesia must occur in concert with damage control resuscitation and surgery to optimize the physiology of the shocked patient, while ensuring adequate surgical conditions for the operative team. Damage control anesthesia encompasses a variety of procedural skills, from the induction of anesthesia to advanced airway management techniques and to the full spectrum of vascular access options. Beyond providing only procedural assistance in the resuscitation, the anesthesiologist offers the unique perspective of a physician who spends each day monitoring and correcting deranged physiology in the operating room. Participation in the initial phases of trauma care ensures seamless transition from the trauma bay to the operating room and into the intensive care unit. A consideration for resuscitation end points and their impact on multiple organ systems is vital to the successful conduct of damage control anesthesia. The following chapter will review the anesthesiologist's role in the induction of anesthesia, airway management, and hemodynamic monitoring of the trauma patient, as well as resuscitation end points, neurotrauma concerns, renal protection issues, and pulmonary management.