The aim of this handbook is to provide guidance for trained anaesthetists working for the ICRC and to offer advice in areas where practice will differ from that in their home country. It is designed to supplement the practical training given in ICRC war-surgery seminars and to support the work of the ICRC in war surgery. Even in the most austere of conditions it is imperative to realize that anaesthesia is always a significant medical intervention and entails a degree of risk.Despite the constraints of the austere environment, minimum standards of conduct and monitoring must be followed with the emphasis always on safety and simplicity. Flexibility is a key requirement. It is vital to remember that having the skills to pursue a particular course of action does not necessarily mean that you should do so. Anaesthetic techniques may need to be adapted to the prevailing circumstances.