Author: James Prudden
The medical team that oversaw the successful rescue of 12 Thai soccer players and their coach has been very guarded in their comments following the event, refusing to be interviewed by us and others interested in how they did it.
Well, now we know some facts. In a letter to The New England Journal of Medicine(2019;380:1372-1373), Richard Harris, BM, BS, FANZCA, an anesthesiologist who led the medical effort and devised the rescue protocol, explains—together with three Thai medical colleagues—some of the details surrounding the rescue.
The boys were all administered ketamine, a vasoconstrictor that reduces shivering, and most were given non-rebreather oxygen masks and sunglasses for eye protection. Reports have noted that the boys also received alprazolam for anxiety and atropine to prevent muscle spasms.
Hypothermia was a major concern, so an anesthesiologist was assigned to oversee hypothermia management once the boys were pulled from the cave but before they were moved to the hospital. Cloth blankets, heated blankets, foil wraps and a forced-air warming device were all used. In addition, the rescued boys were given a bolus of 100 mL of warmed 0.9% normal saline, and then infused 150 to 200 mL per hour until they were judged to be hemodynamically stable. Core temperatures were obtained with tympanic membrane monitoring; a temperature of 35.0° C was required for at least four readings before allowing transport to the hospital.
After more than two weeks in the Tham Luang cave, all boys and their coach were successfully removed, although two of the boys experienced mild, transient hypothermia. None has had any ill effects since the rescue.