Here is attached an interesting non technical article published in 1995 in the British Journal of Anaesthesia regarding the role of thiopentone anaesthesia in fatalities during emergency medical care after the Japanese attack on Pearl Harbour. I thought it might be interesting to people or create discussion.
Thiopentone is a barbituate anaesthetic agent. I remember being told "Thiopentone killed more people at Pearl Harbour than the Japanese". The story was that use of thiopentone caused many American casualties during treatment for injuries sustained in the attack. It is certainly a drug that must be used with care in shocked or debilitated patients due to cardiovascular depressant effects and had only recently been commenced in large scale use prior to the attack. So there was the implication that unskilled use contributed to casualties.
One thing I incidentally noticed in the article is the fact that large doses appear to have been used compared to currently recommended doses. In the article one Pearl Harbour doctor is quoted doctor is quoted saying "In several cases when as small an amount as 0.5g was administered there suddenly occurred a 'cyanosis décolletage' that was the inevitable and irremediable precursor to death". Note that this states a small dose is 0.5g or a dose of 0.007 grams per kilograms in the average 70 kg male. The current recommended dose at start of anaesthesia is 0.003 to 0.005 grams per kilogram in well patients or 0.001 to 0.0025 grams per kg in debilitated patients. This equates to a maximum dose of 0.35g in a well 70kg male and 0.175g in an average 70 kg debilitated or shocked patient.
The article explores the currently known facts about the fatality rate with the rumoured death rate and suppression of information during the war.
The reference is British Journal of Anaesthesia 1995; Vol 75, p366-368, http://bja.oxfordjournals.org/content/75/3/366.full.pdf
I hope it is of interest