Ambulatory_Anesthesia_2013_Layout 1 6/26/13 2:21 PM Page 30
I N H A L A T I O N
A G E N T S
GAS MAN
Effective Low-Flow Training
I
f your anesthesia providers are interested in starting a low-flow program,
point them first in the direction of a talk
and tools developed by James H. Philip,
ME(E), MD, an engineer based at Harvard
EXPERT ADVICE Providers interested in adding low-flow
skills should learn from James H. Philip, ME(E), MD.
University in Boston.
"Gas Man" is an amazing online resource check out the website. They'll learn what to
for residents to learn anesthetic uptake and
look for when things aren't going well, and
distribution. Experienced providers can also
how to maintain anesthesia levels and the
simulate and experiment with new methods
like, so they understand the science behind
of administering anesthesia, such as low
the technique before implementing it in
flow, before they use them live. It's a practi-
practice.
— Clifford Gevirtz, MD, MPH
cal and easy-to-use clinical tool, in my
experience.
On the Web
If you're trying to introduce low-flow
• Gas Man: www.gasmanweb.com
• "Low Fresh Gas Flow Oxygen and Agent
Considerations" by James H. Philip, ME(E),
MD: tinyurl.com/kybbrqx
anesthesia into a department in which it's
never been done before, have the providers
ate for anyone who's a candidate for
When it matters most
potent inhalation agents. Typical low-
Low-flow anesthesia is most appropri-
flow applications include extensive gas-
ate in operations lasting longer than
troplasties, cosmetic and plastic surger-
an hour. In ambulatory surgery, the
ies, urology (such as vas deferens
longest procedures can extend past 4
reconstructions) and GYN. Low-flow
hours. During these cases it's most dif-
anesthesia can even be used for longer
ficult to maintain normothermia. But
pediatric cases, a patient population for
when you do, patients will wake up
whom maintaining normothermia is a
faster and reach discharge criteria
huge issue.
more readily. These needs are especially pressing in freestanding centers,
3 0
SUPPLEMENT
TO
O U T PAT I E N T S U R G E R Y M A G A Z I N E | J U LY 2013
V
T
d
p
I
K
