A field-expedient Ohmeda Universal Portable Anesthesia Complete draw-over vaporizer setup

The Ohmeda Universal Portable Anesthesia Complete (U-PAC) draw-over anesthetic system is active in the US Army inventory. It is standard equipment for Certified Registered Nurse Anesthetists assigned to US Army Forward Surgical Teams and Joint Special Operations Command. The purpose of this article is to describe a practical and field-expedient U-PAC draw-over vaporizer setup used during Operation Iraqi Freedom I (February 2003 to July 2003). During the deployment, general anesthesia was administered to 25 patients with penetrating trauma using the Gegel-Mercado setup without system malfunction. This setup strengthens the standard U-PAC draw-over system delivery because it increases fractional inspired oxygen concentrations, promotes hands-free operation, enhances circuit cleanliness reducing cross contamination, and provides an alternate method for draw-over anesthesia administration in austere conditions when a ventilator may not be available or practical. It integrates and builds on the core concepts of draw-over anesthesia delivery in the literature. The Gegel-Mercado setup is combat proven.