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    In this undated photo released by Royal Thai Navy on Saturday, July 7, 2018, Thai rescue team members walk inside a cave where 12 boys and their soccer coach have been trapped since June 23, in Mae Sai, Chiang Rai province, northern Thailand

    Thai Soccer Team Were Sedated With Ketamine for Dangerous Cave Rescue

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    During the dangerous underwater rescue mission that caught the world’s attention last July, the 12 young soccer players trapped in a cave with their coach in Tham Luang, Thailand, were dosed with ketamine to help keep them calm and to ward off potential hypothermia as they were dragged out through cold waters.

    What was meant to be a fun excursion for the "Wild Boars" soccer team quickly turned into a harrowing struggle for survival as the teenagers and their coach became trapped by flood waters deep inside a complex cave system in late June 2018. They remained in the cave for 17 days before the last group of boys, along with their coach, were rescued on July 10.

    An international team of divers was assembled to rescue the trapped boys and their coach, but the heavy rains and the dark and complex cave system would make the rescue anything but easy, even for the experienced team. Saman Gunan, a former Thai Navy Seal, died during the operation when he ran out of oxygen on a dive.

    To help keep the boys calm under the dangerous conditions, the organizers of the rescue mission gave them ketamine. Their experience could prove useful in treating other patients who might be susceptible to hypothermia while far from hospitals, the rescue organizers wrote in a letter published by the New England Journal of Medicine.

    "The [rescue] plan involved the use of ketamine-based anesthesia and a positive-pressure full-face mask (supplying 80% oxygen); the boys were swum out of the cave wearing poorly fitting wet suits in cold water," the letter, authored by Chanrit Lawthaweesawat, deputy secretary general of the Medical Association of Thailand in Bangkok, and other Thai authorities and members of the rescue team, explained.

    Richard Harris, an Australian anesthesiologist who co-authored the letter, noted that as too high a dose of the drug can cause complete unconsciousness or panic, the divers had to carefully administer just the right dosage — enough to keep the boys calm, but not so much that they'd have to struggle with a panicking patient as they both tried to squeeze through cold, flooded passages. The letter writers cited the ketamine and the other steps they took in what they described as a "successful prehospital medical care of a series of anesthetized patients with hypothermia after a submerged cave rescue."

    Jeffrey L. Apfelbaum, an anesthesiology expert at the University of Chicago, commended the rescue team for its precision. "The skill set necessary to get these kids out is just unbelievable," Apfelbaum said, the Los Angeles Times reports. "There are countless ways, both medical and from a diving perspective, where tragedy could have occurred. By no means was any of this straightforward."

    Once the boys were above ground, they were made to wear sunglasses because their eyes had not been exposed to sunlight in the last two weeks.

    Earlier this year, CNN reported that the boys would be soon securing a deal with Netflix, in partnership with SK Global Entertainment, the company behind the recent blockbuster movie, "Crazy Rich Asians."

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    dangerous, cave, diver, mission, rescue, soccer, Thailand
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