tion, you can proba-
bly get by with a
very simple
machine. You just
want to make sure
you have a monitor-
ing mode to elimi-
nate false alarms
when the patient is
breathing on his
own and you're sim-
ply monitoring that breath. Of course, clinicians in such a setting may
not be planning a general anesthetic, but some still want to have a
machine, in case the patient goes apneic and needs to be intubated
and ventilated. A simple machine that provides ventilation and CO
2
absorption may be all you need.
2. How many cylinders do you need, and which ones? Assuming you
have oxygen and air piped into the OR (which virtually all modern
facilities have), the question is what sort of backup you need in the
event of a medical gas failure or natural disaster. Most new machines
have space for at least 2 cylinders. Since extra oxygen is a given for
one, the question becomes what you want the second cylinder to be.
Most facilities choose air, which is especially important if you're doing
plastic surgery on and around the face, since oxygen buildup is a
major fire hazard. The same consideration is warranted for neonates
and some chemotherapy patients, both of whom are vulnerable to
oxygen lung toxicity. But depending on your patient population, you
might also choose to go with 2 oxygen cylinders. Nitrous oxide is also
a possibility, but modern anesthetic agents are so short-acting that
1 5 8
O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | O C T O B E R 2 0 1 5
z WHAT'S NEW? Younger anesthesiologists might be more inclined to embrace
new technology, but don't assume all senior providers are technophobes.
John
Newman,
Duke
Anesthesiology
