Critical care in the austere environment: providing exceptional care in unusual places.

Background: War and other disasters are inexorably linked to illness and injury. As a consequence of this, healthcare providers will be challenged to provide advanced physiological support to preserve human life. Given the mobility and modularity of modern medical systems, the ability to provide critical care outside of the confines of traditional hospitals under such circumstances has become not only a reality and periodic necessity, but an expectation.

Organizational characteristics of the austere intensive care unit: the evolution of military trauma and critical care medicine; applications for civilian medical care systems.

Critical care in the U.S. military has significantly evolved in the last decade.

Chemical burn injury secondary to intraoperative transesophageal echocardiography.

Unlabelled: We describe a case of a 72-yr-old male who suffered aerodigestive tract chemical injury resulting from a probable post-processing residual of the high-level disinfectant solution Cidex OPA (ortho-phthalaldehyde) used to disinfect the transesophageal echocardiogram probe used for cardiac monitoring during general anesthesia. This case highlights the need for strict adherence to manufacturers' instructions when using chemical disinfectants for transesophageal echocardiogram probe reprocessing.

Implications: We describe a case of aerodigestive tract chemical injury resulting from a probable post-processing residual of the high level disinfectant solution Cidex OPA (ortho-phthalaldehyde) used to disinfect the transesophageal echocardiogram probe used during general anesthesia.