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serviceability of a given piece of equipment.
3. Interoperability
This is a tricky area. Ten or 15 years ago, I'd have had no problem advising most
outpatient facilities to buy used or refurbished anesthesia machines as cheaply
as possible — as long as they could be used to treat patients safely and effec-
tively. But if you buy an older machine today, it might not be able to interface
with EMRs, quality assurance programs and billing systems. That's an important
consideration in today's digital world.
Outpatient facilities have so far been spared the edict to convert to EMRs. If
you work in a surgery center that hasn't yet gone paperless, it might be a cost-
savvy decision to settle for an older machine now and put off investing in an
upgraded model until your facility is required to make the conversion to elec-
tronic recordkeeping. There's no doubt that day is coming, however, so if
you're planning to buy a new machine, you'll want one that lets you enter and
record all electronic data as efficiently as possible. Be sure any new machine
you're interested in can interface with your facility's electronic records. Do
your research to know what you need and what you're buying, and don't settle
for anything less than full interoperability.
4. Low-flow capabilities
Volatile anesthetic agents like sevoflurane and desflurane are expensive, so any-
thing that reduces the volume you use is going to save money. If you're in the
market for a new machine, you'll likely hear a lot about low flow — the anesthe-
sia equivalent to using the autopilot system in a plane at cruising altitude.
The idea behind low flow is fairly simple. Once the patient is asleep (at cruising
altitude, you might say), the goal is to maintain that steady state with just the right
mix of fresh gas (air, oxygen and/or nitrous oxide) and vaporized anesthesia
agents. The less fresh gas you use, the less anesthetic agent you need to maintain
the same mix and the same steady state.
