Boys trapped in Thai cave were drugged for risky rescue dives
latimes.com
latimes.com
> A word about sedation. A word, too, about Dr. Harry.
> Anaesthesiology requires more training than most branches of medicine; there is always some risk that when a patient is put under, he or she will never wake up. When the patient is a child, the risks are greater. When the child is yanked along underwater for hours through a dark, cold cave, the risks are incalculable—no one has ever done anything like this before.
> Dr. Harry believes the risks of sedating the children beat the risks of not sedating the children. The lead divers believe the same, and the Thais believe the experts know best. The children cannot dive; the children will panic; the children will drown their rescuers and themselves. That is why Dr. Harry is going to do this: inject 12 kids with a sedative so powerful it will knock them out cold.
> Ketamine: a horse tranquilizer, an operating-room drug, a soon-to-be cave-rescue pharmaceutical product in its early testing stages on rock-entombed human minors.
> If only it were so simple. The children’s drugs will need to be topped up with half-doses along the way. Dr. Harry cannot dive every child out himself, but the divers are not medical doctors. Dr. Harry must give a dozen cave hobbyists and small-business owners a crash course in do-it-yourself anaesthesiology.
> If anyone dies—and many divers think they will be lucky to save two or three of the kids—Dr. Harry will bear much of the burden. He is not licensed to practice medicine in Thailand, let alone teach other foreigners to practice. Though Thailand and Australia have offered some assurance that he won’t suffer legal consequences for his young patients’ probable deaths, a conscience and a name are not so easily protected.
Edit: To add, all parties in this emergency agree it was necessary, so they didn't do anything without consent.
This is my favourite tidbit about Ketamine. It is always described in a way to imply that it is a very strong tranquilizer. Though AFAIK the reason it is used for horses is that it is fairly safe to use even when you don't know exactly how much mass the body has that you are trying to sedate. This applies for small bodies as well.
edit: ah yeah. potentially stupid question. obviously if something starts going wrong, even the most level headed people may panic.
As a diver you are usually calm and rational when dealing with expected risks (low air, bad visibility, etc.) but anything unknown or unexpected can trigger panic.
A friend of mine is a commercial diver and he has stories of seasoned co-workers panicking for extremely weird reasons.
A most recent example was on my last trip I tried UV-light diving, which is when you only use UV-light with a filter on your mask to protect your eyes. You get to see some incredible new things. The divemaster stressed how important the filter was to protect your eyes. During the dive the filter on my mask came off. As instructed, I immediately closed my eyes and Waited for the divemaster to notice and tap me to let me know they had switched back to white light and it was safe to reopen my eyes. That half minute felt like an eternity.
A number of unusual situations can trigger a panic. Primary regulator failure, your mask being knocked off, unexpected fauna behavior, becoming lost, losing your group or your buddy, unexpected currents. All of this is covered in the training/certification, but not all training is equal, adequate, or regularly revisited.
What was the model of dive light used? Was is a long-wave light like those in tanning beds or disinfecting lamps? I would imagine that any light unsafe for your eyes would also be damaging to the coral and fish.
First, the kind of diving is more commonly referred to fluorescent diving and it doesn't use UV light, its blue (440-480nm) light. Second the filters were yellow light filters to remove the remaining light so that it didn't overwhelm the blue and you could see the fluorescence.
To warn you, it is fairly disturbing.
I am a seasoned and experienced diver. I used to dive literally on a daily basis. Until that one time when without warning I totally freaked the fuck out at 20 mtr over nothing at all, with only UP UP UP UP UP on my mind. I managed to keep a lid on it and safely ascend, but that was also my last dive. I am not sure this will won't happen again, and I could endanger my buddy, group, or myself.
I don't view drugs as "scary" or "bad". They're tools, if used correctly they can effectively do what you need them to. There's risks with these tools of course, and those need to be considered, but in the end they're just tools. (Not talking about miss-using drugs, only talking about approved usage by professionals)
Ketamine is much less risky than propofol, but I'm sure any doctor would understand the dangers of putting kids that young under that are already in a health danger zone and having them not be monitored.
Well answer your question about why this is interesting to people. The difference between mis-use and proper use is the interesting question. This is not an approved use of ketamine, and the people administering and issuing the drugs were not licensed professionals.
brief? the author must not party very much.
Crazy. Definitely not an easy job.