What do we do until the future gets here?

We have seen that there are serious design inadequacies in the basic anesthesia machines now in the marketplace. None of these meets criteria for technologic soundness or clinical utility elaborated in previous chapters. It is tempting to simply buy what is available and shrug one's shoulders over the situation. Those in desperate need of replacement equipment should go ahead and buy, because significant changes may be years away. However, those who are able and disposed to wait for real progress may accelerate the process by waiting not silently but loudly. Until the anesthesiologists on the firing line are consistently asking technically sophisticated questions related to safety and efficacy, expecting them to be answered, and letting their equipment budgets speak where words do not, we can expect consistent laissez-faire attitudes and actions from the anesthesia machine industry. Technology already available in other industries will continue to be overlooked or ignored, and our clinical needs will be unmet until industry is convinced that the majority of anesthetists want far-reaching substantive change in anesthesia delivery system design. We have no choice but to use what is currently available; but we can reward solid, thoughtful innovation with our capital equipment dollars, with our support of research in anesthesia technology, with our verbal and written requests to manufacturers, and with our individual time spent staying abreast of technologic issues. The ultimate beneficiaries are our patients; we cannot remain static--we must improve.