Training for wartime anesthesia in Sweden

Sweden has been spared from wars and similar disasters for almost two centuries, and over the years the population and politicians have been lulled into the belief that "it'll never happen". This has affected the ability of the medical system to respond adequately to the enormous demands that a war would make upon us. The geographical and political situation and the basic facts about Swedish health care are briefly sketched. After a review of the history of anesthesia in war, current medical planning for war or similar disaster situations in Sweden is outlined and its weaknesses mentioned. A program is presented that aims at improving the situation in anesthesia manpower, postgraduate training and equipment. The expanded role of the already highly skilled and independent Swedish corps of nurse anesthetists (RNA's) is outlined, especially in the field of regional anesthesia. Standardized methods for anesthesia in war also are presented. The aim is to make optimal use of existing resources and enable patients to be transferred immediately postoperatively to understaffed wards.