[Kalium]

> So, how would one be productive about it?

One might start by observing that there are reasons these things aren't air-gapped. A person could go on to note which of these reasons continue to apply and are considered compelling by those who make the relevant decisions, and thus that air-gapping is likely to persist.

[ziddoap]

I wasn't being facetious with my question, it was made in good faith. As I'm not familiar with hospital infrastructure, nor hospital equipment, could you explain to me what reason (other than updates, which is being debated here) an anesthesia machine should not be air-gapped?

[Kalium]

Updates, remote monitoring and remote management all come to mind. Further, integration with other instruments is something that is sometimes considered valuable and difficult to do when everything is airgapped from everything else.

[jacquesm]

Updates should not happen while a patient is under treatment using the machine. Remote monitoring can be done through an airgap (one way optical bridge) that does not have the ability to influence the machine. Remote management while a patient is being treated sounds wildly irresponsible.

So maybe the system could be connected to the network except for when it is treating a patient. A big red slider with 'On Air/Isolated' could be present which would lock out the patient treating options as soon as the machine is networked. Now, this would still leave some gaps: an update could be faulty, a malicious actor could install something that triggers only after a while or when the machine is used to treat a patient. But it would remove a lot of the concern I have with equipment like this being online all the time.