Greetings from Honduras, where I am serving as anesthesiologist for a Volunteer Head and Neck Surgical Team. We are at a small 26 bed charity hospital in the small town of Sula doing many different cases such as tonsillectomies and septoplasties for severe obstruction, and tympanoplasties for chronic ear perforations, among other cases.

Doing anesthesia in the developing world is always challenging, as you don´t have all of the equipment, supplies or even medications that you would normally use. Yesterday was a case in point. My anesthesia machine in Honduras gets it´s oxygen from an H cylinder. So in addition to watching all of the other monitors and dials we normally watch, you have to keep one eye on the manometer to make sure you´re is not going to run out of oxygen in the middle of the case.

All oxygen tanks contain liquid oxygen. As long as there is any liquid in the tank, the manometer will read full. Once the last drop of liquid has vaporized, and the oxygen gas in the tank starts to be used up, then the manometer reading will start to drop. And sure enough, when the tympanoplasty we were doing took longer because it turned out to be more difficult than expected, my manometer began to  plummet, even though I was running low flows. Fortunately I was prepared. Continue reading →