title: The environmental impact of the Glostavent® anesthetic machine.
abstract: Because anesthetic machines have become more complex and more expensive, they have become less suitable for use in the many isolated hospitals in the poorest countries in the world. In these situations, they are frequently unable to function at all because of interruptions in the supply of oxygen or electricity and the absence of skilled technicians for maintenance and servicing. Despite these disadvantages, these machines are still delivered in large numbers, thereby expending precious resources without any benefit to patients. The Glostavent was introduced primarily to enable an anesthetic service to be delivered in these difficult circumstances. It is smaller and less complex than standard anesthetic machines and much less expensive to produce. It combines a drawover anesthetic system with an oxygen concentrator and a gas-driven ventilator. It greatly reduces the need for the purchase and transport of cylinders of compressed gases, reduces the impact on the environment, and enables considerable savings. Cylinder oxygen is expensive to produce and difficult to transport over long distances on poor roads. Consequently, the supply may run out. However, when using the Glostavent, oxygen is normally produced at a fraction of the cost of cylinders by the oxygen concentrator, which is an integral part of the Glostavent. This enables great savings in the purchase and transport cost of oxygen cylinders. If the electricity fails and the oxygen concentrator ceases to function, oxygen from a reserve cylinder automatically provides the pressure to drive the ventilator and oxygen for the breathing circuit. Consequently, economy is achieved because the ventilator has been designed to minimize the amount of driving gas required to one-seventh of the patient's tidal volume. Additional economies are achieved by completely eliminating spillage of oxygen from the breathing system and by recycling the driving gas into the breathing system to increase the Fraction of Inspired Oxygen (FIO2) at no extra cost. Savings also are accrued when using the drawover breathing system as the need for nitrous oxide, compressed air, and soda lime are eliminated. The Glostavent enables the administration of safe anesthesia to be continued when standard machines are unable to function and can do so with minimal harm to the environment.
authors.affiliation: From the *Safe Anaesthesia Worldwide, Marden, Kent, United Kingdom; and †Diamedica (UK) Ltd., Barnstaple, Devon, United Kingdom.
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Eltringham
authors.forename: Robert C
authors.initials: RC
authors.lastname: Neighbour
mesh_terms: D000280:Administration, Inhalation; D000764:Anesthesia, Closed-Circuit / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation*; D000768:Anesthesia, General / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003906:Developing Countries / Q000191:economics; D011211:Electric Power Supplies; D004784:Environmental Monitoring / Q000379:methods; D004867:Equipment Design; D004868:Equipment Failure; D017048:Health Care Costs; D006297:Health Services Accessibility; D006801:Humans; D019570:Inhalation Exposure; D016273:Occupational Exposure; D010100:Oxygen / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D061214:Patient Safety; D012121:Respiration, Artificial / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation*; D018570:Risk Assessment; D012122:Ventilators, Mechanical / Q000191:economics
chemical_list: D010100:Oxygen