SummaryW e have reviewed the availability of apparatus which permits the maximum use to be made u/ uvailuhle supplies and services in developing countries. In particular we have stressed the use of electrically operated uir compressors and oxygen concentrators to drive sophisticated anaesthetic apparatus which is not dependent on supplies ojcompressed gases in cylinders.
Key wordsEquip men I . 0.yygen; delivery bystems.In the previous paper' we have considered the problems of inhalational anaesthesia in developing countries, with particular reference to the supply of compressed gases. We pointed out that many countries, including West Africa, are equipped predominantly with anaesthetic apparatus designed for use with continuous flow of gases from a store of compressed gases and most of their anaesthetists have been specifically trained in such techniques. Unfortunately, there are severe financial and logistic problems in ensuring an adequate supply of cylinders of compressed gases and sometimes no compressed gases of any sort are available. Drawover equipment using atmospheric air is usually available. It is essential for the maintenance of a service but its usc is not universally popular. Thcre are many anacsthetists in these countries who would welcome the possibility of using continuous flow techniques.In the latter part of our previous paper. we formulated design characteristics for apparatus which maximised the potential of mains electricity and which could operate at increasing levels of complexity as facilities and supplies became available. We suggested four modes of operation as follows. mod^ A . No services or supplies other thun volatile unaesthetic agents. These conditions are best met by established drawover techniques.Mode B. As above, with the addition of small quantities ofconzpressed oxygen. Under these conditions, the air inlet should be adapted to admit a low flow of oxygen, using principles which are already well understood.Mode C. As above with the addition ofelectricity supplies. It is now possible to provide a continuous flow of air from a compressor, to obtain oxygen of adequate purity from an oxygen concentrator and to drive an artificial ventilator, either directly from electricity or from compressed air. Mode C can provide all the facilities T.I.