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A theoretical analysis has been performed to show the interrelationships between alveolar carbon dioxide concentration, carbon dioxide output, alveolar ventilation and fresh gas flow during controlled ventilation with the Mapleson D system. The model and forms of equation used have been substantiated by experiments in which dogs were ventilated through a coaxial version of the Mapleson D system at varying levels of fresh gas flow and alveolar ventilation. By assuming that man ventilated with this system behaves as does the dog, a nomogram has been produced to predict alveolar carbon dioxide concentrations at any levels of fresh gas flow and minute volume.

Fixed performance oxygen masks operate by supplying mixtures of oxygen and air at rates exceeding the inspiratory flow rate of the patient. In this study the oxygen concentration delivered by three fixed performance oxygen masks was determined non-invasively at various inspiratory flow rates. At low inspiratory flow rates all the masks studied acted as fixed performance devices. When the peak inspiratory rate increased the performance of all the masks showed some variability. The change from fixed to variable performance depended on the relation between inspiratory flow rate and the total gas flow delivered by the mask and was independent of the volume of the mask.Hence the use of low volume masks and high oxygen flow rates should produce more consistent results than high volume masks and lower flow rates.

Trained nurses using a rule‐based computer program can successfully carry out pre‐anaesthesia screening. All medical problems and abnormal laboratory results need to be reviewed by an experienced anaesthetist. Following the introduction of this system, there was a reduction in the frequency of cancellations of patients from elective orthopaedic operating lists from 4.8% to 1.8%, a difference that was statistically significant (p = 0.03, CI = [0.6%, 5.5%]). To minimise cancellations from booked operating lists, a booked admissions policy is essential, so that the anaesthetist who will eventually be responsible for patients with medical problems can be identified. Cancellations cannot be avoided completely because some abnormal conditions arise or deteriorate after completion of the screening process. The anaesthetist responsible for the patient's anaesthetic may have different views of the risks involved from those of the anaesthetist undertaking the screening process.

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