trust invisible complexity and they've developed remarkable skill at
troubleshooting technical problems. Some providers prefer standard
needle valves that can be opened mechanically, as opposed to newer
fresh-gas delivery systems that are operated by computer. Some may
prefer conventional vaporizers, even though electronic vaporizers offer
certain advantages, such as providing readouts that tell you how much
gas you're consuming and how much money you're spending on differ-
ent gases. Electronic vaporizers may also promise less maintenance.
4. Economic considerations at the purchase level. What sort of budget
are you dealing with? Some hospitals may be in a position to sweep
out all their old machines and replace them with brand new high-tech
models. A smaller freestanding outpatient facility may have to consid-
er a piecemeal approach. If you're going to be buying 2 machines a
year, but ultimately want to replace the 10 you have, it makes sense to
stay with the same company and same technology. Consider the
expected lifespan of the machine and whether it will survive a long
phase-in period. Machines break down, and that's a problem, whether
the people who have to fix them are in-house or not. If they're not,
you have to contract with machine-specific trained technicians to
keep them operating. If you have in-house biomeds, similarly, you
have to send them to training for every new kind of machine you buy.
After all, somebody has to be certified to fix that machine, and those
courses are very expensive.
5. Value after purchase. New machines range from about $35,000 to
about $100,000, but spending more now may cost less in the long run.
Machines that save money by allowing low fresh-gas flow and that let
you manage your more difficult patients without having to swap out
machines or borrow a ventilator from an ICU might pay for them-
1 6 0
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
