<p>An underlying fear for many in using new digital systems is not the 'digital' but the struggle to trust and see reality; this may represent the loss of an art or aesthetic judgement, over an empirical measurement.(1) Why do we have what we have - and what could we have? Since the acceptance of the "Boyle's" configuration as a design standard, the evolution of anaesthesia equipment has predominantly remained tethered to this design icon.(2) Increasingly governed by historical habits and industrial ideologies, significant gains in technology have denied anaesthetists ergonomic advantage, due in part, to a design stagnation of physical composition. In doing so, it has become a legend of origin and a convention of machine use, a situation that is traced back to the evolution of rag and bottle, portable inhaler, and the asymmetric layout of anaesthetic apparatus. One of the key difficulties or questions for design is how to implement new technologies to retain and strengthen the established product-person trust.(3) The past reveals two methods; first the traditional addition of technology to historical brands and established formats; and second, the innovative embodiment of task and technology in a search for better systems.(4) Within the evolution of the anaesthesia machine, design methodologies have colluded to satisfy safety, ignoring a profession's habits, resulting in a complex lamination of engineering (technology), interaction (ergonomics) and aesthetics (path dependence and manufactured style). The application of new digital technology demands a physical design response that can satisfy clinician needs, patient safety and the commercial goals of industry in balancing technology and safety to clinical outputs and user satisfaction.(5) The study presents an informative and investigative methodology to construct a proactive design base, cumulating in active involvement, an informed critical analysis and a prospective methodological vision. The concluding experiment focuses on information and ideals from anaesthetists, to firstly test the established composition; secondly to inform us of how anaesthetists envisage their equipment; and thirdly, how simulation and industrial design may partner in unlocking the transfer of creative knowledge. In applying this partnership as a strategic design confidant, a new understanding of design process and concomitant design within an elite profession is established. Altogether this thesis seeks to explore the anaesthesia machine, to investigate the past, create closer relationships with anaesthetists and act together prospectively towards questioning the established. It may be 'it is not a solution we are looking for but the right way (or process) to ask the questions’ to manifest a new answer. (1) B Guy, "The anaesthesia machine: questioning a design evolution" (Thesis., Victoria University of Wellington, 2010), vii (2) K Bryn Thomas, The development of anaesthetic apparatus ( London UK: Blackwell Scientific Publications, 1975), viii (3) M B. Weinger, "Anesthesia equipment and human error," Journal Clinical Monitoring and Computing 15 (Jul 1999): 319-323. (4) O M. Watt, "The evolution of the Boyle apparatus, 1917-67," Anaesthesia 23 (1968): 103-118. ; G Boquet. J A. Bushman. H T. Davenport, "The anaesthesia machine: a study of function and design," British Journal of Anaesthesia 52 (1980): 61-67. ; Jeffrey B. Cooper. Ronald S. Newbower. Jeffrey W. Moore. Edwin D. Trautman, "A new anesthesia delivery system," Anesthesiology Vol 49 No 5 (1978): 310-318. (5) B Moggridge, Designing interactions (Cambridge, Mass: MIT Press, 2007), 579.</p>
Innovation and New Technologies in Spine Surgery, Circa 2020: A Fifty-Year Review