You arrive on a Saturday for an urgent hip manipulation under general anesthesia when you notice a high-pitched, unfamiliar alarm and discover that the entire hospital lost central vacuum. You call the nursing supervisor and share that a lack of suction raises significant safety concerns for the anesthesia team. She reassures you that your ortho OR has stand-alone suction and that there are portable suction machines available for recovery. While that may solve the secretion/vomiting problem, you worry about the implications for the anesthesia machine. You contact the on-call biomedical technician who states that they usually outsource anesthesia machine maintenance and is unsure what it means.

So, what does it mean? What are the machine implications? Is it safe to proceed? Dr. Loeb and Sem Lampotang provide the following perspective:

It is safe to proceed with this hip manipulation under general anesthesia without central vacuum, but with two caveats. The...

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