This brief report, published in the New England Journal of Medicine today (April 3), describes how the boys and their coaches were treated immediately after being pulled out of the cave and before being taken to the hospital by helicopter or ambulance.
When the doctor first saw these boys, they had been anesthetized by ketamine, so that they would lose consciousness in the arms of experienced divers during the difficult cave trip. According to CNN, these boys don't know how to swim. It is reported that they spent several hours in cold water wearing "ill-fitting diving suits", which means that they are in danger of hypothermia.
Dr. Chanrit Lawthaweesawat, an anesthesiologist at Bumrungrad International Hospital in Bangkok, and the deputy secretary-general of the Thai Medical Association, said that these diving suits were not suitable, partly because many boys were hungry for a long time and lost weight. [Photo: Rescuers race against time to save the football team trapped in a cave in Thailand]
The report said that these patients were immediately given oxygen masks and sunglasses to protect their eyes from the sun for weeks. Doctors should be careful when taking off clothes that don't fit patients, so as not to hurt them or hinder their normal breathing.
Boys and their coaches also use blankets to keep warm and regularly monitor their body temperature.
On the first day, one of the four rescued boys developed hypothermia when being airlifted to Prechanuk Hospital in Chiang Rai. When he arrived at the hospital, his temperature was 94.6 degrees Fahrenheit (34.8 degrees Celsius). When a person's temperature drops to 95 degrees Fahrenheit (35 degrees Celsius) or lower, it is considered as hypothermia. After the first day, the doctors made what they called "Thailand Cave Rescue Plan", focusing on the most critical problems faced by the children, mainly involving the factors affecting breathing and hypothermia. Doctors call the scheme "ABC+H", which stands for "airway, respiration, circulation and hypothermia". Respiratory doctors, pediatric cardiologists and anesthesiologists were assigned to pay attention to these problems.
Dr. Aaron Billing, the former president of the Battlefield Medical Association who was not involved in the rescue, called this method "very creative and a quick plan for a very unique situation."
Because this situation is very special, it is difficult to extend the process to other environments, but "it works well in this case," Billing told field science.
Other measures to prevent hypothermia include the use of heating blankets and full-body foil wrapping. On the way to the hospital, the patient also received an injection of warm saline to help prevent hypothermia.
It sounds like "they took good measures to prevent hypothermia as much as possible," Billing said, noting that the author only reported one case of mild hypothermia.
Taking care of the rescued boy needs a huge medical team, with more than 50 to 60 doctors and 100 medical staff on duty every day. The author said,
The efforts of rescuers and medical professionals finally paid off, and all the boys and their coaches stood the test.
The longest cave in the world. How long can humans live in caves? The real risk of rescuing the trapped boy in ave, Thailand Editor's Note: This article is updated according to a wild medical expert's reaction to this case.
Originally published in Life Science.