Anaesthetists often use a t-piece for paediatric anaesthesia as they are light-weight, have rapid wash in and wash out times, and give the best feel for lung compliance.
However, they are very polluting because they are open circuits, and wasteful as they require at least 6L/minute of gas flow to prevent rebreathing of CO2.
Swedish anaesthetists are very conscious of the potential risks to staff from exposure to volatile, and they do their utmost to reduce pollution. T-pieces are seldom used for this reason. In fact, they don’t exist at the Karolinska University Children’s Hospital.
Unfortunately, pollution by volatile agents in anaesthetic rooms and operating theatres in Australia is not really perceived as a problem. The high turnover of cases and the frequent use t-pieces results in significant spillage of volatile in these areas. T-pieces allowing scavenging are often not available, are expensive and many are clumsy to use.
A very simple alternative scavenging system can be made using a 50ml leur lock syringe attached to the regular suction. The leur lock plugs nicely into the end of the suction tubing.
Although not ideal, as this system does not allow easy scavenging when positive pressure ventilation is used, it noticeably reduces volatile pollution during the majority of a spontaneously ventilating case.