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evacuation hospital via computed tomography on postopera- Financial Disclosure
tive day 3. Oxygen and nasal cannula were available on site, The authors have no relevant financial relationships to disclose.
but in a more austere location and over longer time periods,
this effect would have to be solved through aggressive pul- References
monary toilet. This patient presented with a significant lower 1. Schauer S, April M, Aden J, et al. Impact of continuous ketamine
extremity fracture, which made mobilization as a treatment infusion versus alternative regimens on mortality among burn in-
for atelectasis impossible. tensive care unit patients: implications for prolonged field care. J
Spec Oper Med. 2019;19(2):77–80.
2. Schwenk E, Viscusi E, Buvanendran A, et al. Consensus guidelines
on the use of intravenous ketamine infusions for acute pain man-
Conclusion agement from the American Society of Regional Anesthesia and
Pain Medicine, the American Academy of Pain Medicine, and the
In an austere setting over approximately 48 hours, a continuous American Society of Anesthesiologists. Reg Anesth Pain Med. 2018;
ketamine infusion proved highly effective for analgesia, work- 43(5):456–466.
load mitigation, and supply utilization in an extubated post- 3. Oddo M, Crippa I, Mehta S, et al. Optimizing sedation in patients
surgical patient. Atelectasis, somnolence, and disorientation with acute brain injury. Crit Care. 2016;20:128.
were side-effects that may hamper its use over long durations. 4. KETALAR (ketamine hydrochloride) injection. FDA.gov. Refer-
In a setting where oxygen supplementation or other methods of ence ID: 4089409.
treatment are not available, atelectasis may be a limiting factor.
Author Contributions
A.H. conceived the study concept and wrote the first draft. A.H.,
L.M., and M.D. coordinated and collected the data, revised the
manuscript, and read and approved the final manuscript.
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