PHYSICS
SI units
David Williams
Abstract
This article summarizes the history and application of the Syste
me
Internationale (SI) of units. Non-SI units in common use in anaesthesia
and standard units of digital information are also described.
Keywords Measurement; prefixes; SI; Syste
me Internationale; units
Royal College of Anaesthetists CPD Matrix: 1A03, 2A04, 3J00
Background
The Syst
eme Internationale (SI) d’Unites is a coherent logical
system of measurement based on the metric and decimal sys-
tems, and has been adopted as a worldwide standard since its
introduction in 1960. The SI system will be incorporated into the
existing International Organization for Standardization (ISO) and
International Electrochemical Commission (IEC) standards to
form the International System of Quantities ISO/IEC 80000.
SI units
The value of a quantity is usually expressed as the product of a
number and a reference unit. The SI system defines seven inde-
pendent fundamental or base units, two supplementary units,
and 22 derived units.
Of the base units, six are defined with reference to reproducible
natural phenomena (Table 1). Only one e mass e is defined by a
physical prototype: the International Prototype Kilogram (IPK), a
20% platinum : 80% iridium cylinder manufactured in 1889,
measuring approximately 20 cm
15 cm diameter, kept in a vault
at the international bureau of weights and measures (BIPM) in
S
evres near Paris. This standard may be replaced in future by a
sphere of pure silicon containing a known number of atoms, and a
watt balance. The gram was the fundamental unit of mass in the
centimetreegramesecond (CGS) system (1874); but this was
replaced by the kilogram in the metreekilogramesecond (MKS)
system (1889), and has subsequently been incorporated into the
SI system.
The dimensionless supplementary units are the radian (rad)
and steradian (sr) for plane and solid angles respectively. Derived
units are functions of one or more of the base units; and 22 of
these have been given specific names and symbols for conve-
nience e e.g. the unit of force (m kg s2) is also called the
newton (N) (Table 2).
Some non-SI units have been retained for historical and cul-
tural reasons (Box 1). Units for quantities which describe bio-
logical effects (e.g. sound pressure [dB], equivalent absorbed
David Williams FRCA DipDHM is a Consultant Anaesthetist at the
Welsh Centre for Burns, Swansea, and Honorary Associate Professor
at Swansea University, UK. Conflicts of interest: none declared.
ANAESTHESIA AND INTENSIVE CARE MEDICINE 18:7
Learning objectives
After reading this article, you will be able to:
C define the SI base units, derived units, supplementary units and
prefixes
C define conversion factors for non-SI units in common use
C apply the correct conventions for formatting SI units
ionizing radiation dose [Sv]) often use logarithmic scales (the
WebereFechner law) that do not readily relate to the SI system.
Particular caution should be exercised when using non-SI units,
as conversion errors frequently occur.1
Decimal multiples and submultiples of the base units are
expressed by adding the appropriate prefixes (Table 3).2 Where
no prefixes or conversion factors are necessary, units are said to
be coherent. Hence m s1 and km s1 are both SI units, but only
m s1 is coherent. Formatting of SI units and their prefixes fol-
lows strict conventions (Box 2).
Units of digital information
Digital information (e.g. digital memory and data transfer rates)
is based on the binary system. A single binary digit (1 or 0) is
called a bit (b);3 4 bits ¼ 1 nibble and 8 bits ¼ 1 byte (B). SI
prefixes increase by powers of 10, and therefore only approxi-
mate their binary equivalents, which increase by powers of 2.
The IEC has therefore proposed the following binary prefixes:
1 kibibyte (‘kilo’ þ ‘binary’) (KiB) ¼ 210 B ¼ 1024 B z103 B; 1
mebibyte (‘mega’ þ ‘binary’) (MiB) ¼ 220 B ¼ 1 048 576 B z106 B;
1 gibibyte (GiB) ¼ 230 B z109 B; 1 tebibyte (TiB) ¼ 240 B z1012 B;
1 pebibyte (PiB) ¼ 250 B z1015 B etc.
Area, volume, and capacity
The following terms are frequently used interchangeably in
everyday speech, but have very different meanings. To avoid
confusion, it is best to use mathematical notation.
The derived SI unit of area is the square metre (m2, or sq m).
12 square metres ¼ 12
(1 m2) (i.e. the area of any shape
equivalent to that of 12 squares, each of area 1 m2). This is not
the same as 12 metres square (d) (i.e. the area of a square of sides
12 m in length ¼ (12 m)2 ¼ 122 m2 ¼ 144 m2). Area is propor-
tional to the linear dimension squared, so that doubling the sides
of a square will increase the area by a factor of four (22). When
converting units, the linear unit conversion factor must be also
1
On 23 September 1999, the $300 million Mars Climate Orbiter space-
craft was destroyed due to a flight system software error which failed to
convert thrust instructions from the Imperial units pound-force (lbf) to SI
units newton (N).
2
In the UK a billion is traditionally defined as a million million (106

106 ¼ 1012, or ‘bi(mi)llion’); and a trillion is a million million million (106

106
106 ¼ 1018, or ‘tri(mi)llion’). However in the USA, and increas-
ingly worldwide, a billion is defined as a thousand million (103
106 ¼
109); and a trillion is a million million (106 x 106 ¼ 1012).
3
Named in 1946 by John Tukey, Statistician at Princeton University.
351 Crown Copyright Ó 2017 Published by Elsevier Ltd. All rights reserved.
 PHYSICS

The seven fundamental SI units

Base Quantity Symbol for SI unit SI unit Definition
dimension name symbol

Length l, x, r L metre m 1 m is the length of the path travelled by light in a vacuum during a time
interval of 1/299 792 458 s
Mass m M kilogram kg 1 kg is the mass of a platinumeiridium prototype kept at the BIPM, Paris
Time, duration t T second s 1 s is the duration of 9 192 631 770 periods of the radiation corresponding
to the transition between the two hyperfine levels of the ground state of
the caesiume133 atom
Electric current I, i I ampere A 1 A is the constant current which would produce a force of 2
107
newton per metre of length between two straight parallel conductors
of infinite length and negligible cross sectional area in a vacuum
Thermodynamic T Q kelvin K 1 K is 1/273.16 of the thermodynamic temperature of the triple point
temperature of water
Amount of substance n N mole mol 1 mol is the amount of substance which contains as many elementary
entities as there are in 0.012 kg of carbone12
Luminous intensity Iv J candela cd 1 cd is the luminous intensity in a given direction of a source that emits
monochromatic radiation at a frequency of 540
1012 Hz and that has
a radiant intensity in that direction of 1/683 watt per steradian

Table 1

Some derived SI units in common use in anaesthesia

Derived quantity SI unit SI unit Expressed in terms Expressed in terms
name symbol of other SI units of SI base units

Force newton N m kg s2

Pressure pascal Pa N/m 2
kg s2 m1
Energy, work, amount of heat joule J Nm m2 kg s2
Power watt W J/s m2 kg s3
Electric charge, amount of electricity coulomb C sA
Electrical potential difference, volt V W/A m2 kg s3 A1
electromotive force
Capacitance farad F C/V m2 kg1 s4 A2
Electrical resistance ohm U V/A m2 kg s3 A2
Frequency hertz Hz s1

Table 2

be squared (e.g. 12 m z 12
39.37 inches (in), so 12 m2 z 12

Some non-SI units in common use 39.372 sq in z 1550 sq in).
Similarly, the derived SI unit of volume is the cubic metre
C Time in minutes (min), hours (h) and days (d):
(m3, or cu m); 12 cubic metres ¼ 12
(1 m3) (i.e. the volume of
1 min ¼ 60 s. 1 h ¼ 60 min ¼ 3600 s. 1 d ¼ 24 h ¼ 86, 400 s
any shape equivalent to that of 12 cubes, each of volume 1 m3).
C Capacity in litres (l or L):
This is not the same as 12 metres cube (d) (i.e. the volume of a
1 L ¼ (101 m)3 ¼ 103 m3 ¼ 0.001 m3 (i.e. 1 m3 ¼ 1000 L)
cube of sides 12 m in length ¼ (12 m)3 ¼ 123 m3 ¼ 1728 m3).
C Plane angle in degrees ( ), minutes (0 ), and seconds (00 ):
Volume is proportional to the linear dimension cubed, so that
1 ¼ 600 ¼ 360000 ¼ (p/180) rad
doubling the sides of a cube will increase the volume by a factor
C Pressure in bar, standard atmosphere absolute (ATA), and milli-
of eight (23). When converting units, the linear unit conversion
metre of mercury (mmHg):
factor must be also be cubed (e.g. 12 m z 12
39.37 in, so 12
1 bar ¼ 100 000 Pa. 1 ATA ¼ 101 325 Pa. 1 mmHg ¼ 133.322 Pa
m3 z 12
39.373 cu in z 6.102
104 cu in).
C Thermodynamic temperature in degree Celsius ( C), and degree
A litre (l or L) is a non-SI measure of capacity (i.e. internal
Farenheit ( F):

volume) equivalent to 1 cubic decimetre (Box 1). A millilitre
C ¼ K  273.15;  F ¼ 9/5(K  273.15) þ 32
(ml or mL) is equivalent to 1 cubic centimetre (cc): 1 mL ¼ 103
C Energy (or heat) in calorie (cal), and kilocalorie (Cal):
L ¼ 106 m3 ¼ (102 m)3 ¼ 1 cm3. The use of ‘cc’ is deprecated
1 cal ¼ 1
103 Cal ¼ 4.184 J
as it is not an SI unit, and may be mis-read as ‘00’ on prescription
Box 1 charts, causing a hundredfold overdosage.

ANAESTHESIA AND INTENSIVE CARE MEDICINE 18:7 352 Crown Copyright Ó 2017 Published by Elsevier Ltd. All rights reserved.
 PHYSICS

Medical instrument gauges

Some SI prefixes in common use in anaesthesia
Tracheal tube sizes refer to the internal diameter (ID) (mm);
Factor Name Symbol Factor Name Symbol however, for historical reasons many items of anaesthetic
equipment are frequently still sized in non-SI units.
101 deca da 101 deci d
The external diameter (ED) of hypodermic needles, regional
102 hecto h 102 centi c
and spinal anaesthetic needles, sutures, and intravenous
103 kilo k 103 milli m
cannulae are sized using the US Birmingham (Stubs) or British
106 mega M 106 micro m
Standard Iron Wire Gauge, (I)SWG, or (B)WG (1808), which
109 giga G 109 nano n
originates from the method of manufacture of wire in which iron
1012 tera T 1012 pico p
rods were drawn through a series of conical dies, with each die
Table 3 causing a successive decrease of z11% ED. This ratio was
determined by the tensile properties of iron, and represented the
greatest reduction in diameter which could be achieved without
Basic rules for expressing SI unit names, symbols and causing the wire to break. The modern form of SWG consists of
prefixes 41 sizes in arbitrary increments of 0.0010e0.0460 inches, with an
inverse relationship between ED and SWG which approximates a
Quantity symbols:
geometric series given by:
C Italics, lower or upper case (e.g. n, T )

Dimension symbols: ED (inches) z 0.300
0.897(SWG1)

C Sans-serif upper case roman (upright) (e.g. L, M)
ED (mm) z 0.762
0.897(SWG1)
SI unit symbols:
C Lower case roman; unless derived from a proper name, in which To find the ID, which determines resistance to fluid flow, twice
case a capital letter is used (e.g. m, W) the wall thickness of the cannula must be subtracted from
the ED.
SI unit names:
Urinary catheters, chest drains, pulmonary artery flotation
C Lower case roman (even when derived from proper names);
catheters, and gum elastic bougies are sized using French (Fr) or
except when capitals would be normally used (i.e. at the begin-
Charri
ere (Ch) gauge, developed by French surgical instrument
ning of a sentence, or in a title [e.g. ampere])
manufacturer Joseph-Frederic-Benoı̂t Charri
ere (1803e1876) in
Prefixes: 1842. The system has uniform increments of 1/3 mm between
C Base 10 and binary prefix names are all lower case (e.g. mega- gauge sizes, and no upper limit.
hertz, kibibyte)
Ch gauge ¼ 3
ED (mm) z external circumference (mm)
C Base 10 prefix symbols may be upper or lower case (e.g. kHz,
MHz e see Table 3)
A
C Binary prefix symbols all start with upper case letters (e.g. KiB, MiB)
FURTHER READING
Formatting:
Bureau International des Poids et Mesures (BIPM). The International
C No space between prefixes and unit symbols or names (e.g. kPa,
System of Units. 8th edn. 2006. Paris: BIPM (accessed 9 Mar 2013),
not k Pa; kilometre, not kilo metre)
http://www.bipm.org/utils/common/pdf/si_brochure_8_en.pdf.
C Space between number and unit name (e.g. 10 kPa, not 10kPa)
Conversion factors for non-SI units. http://www.bipm.org/en/si/si_
C Do not use plurals for symbols or names (e.g. 10 cm, not 10 cms;
brochure/chapter4/conversion_factors.html (accessed 9 Mar 2013).
10 centimetre, not 10 centimetres)
Error-prone abbreviations and symbols in medical practice. http://
C Do not mix symbols and names (e.g. 10 m s1; not 10 m per second)
www.ismp.org/tools/errorproneabbreviations.pdf (accessed 9 Mar
C Separate groups of 3 digits around the decimal point with a space
2013).
or comma (optional for 4-digit numbers: 1000, 1,000 and 1 000
Iserson KV. The origins of the gauge system for medical equipment.
are all correct)
J Emerg Med 1987; 5: 45e9.
C Indicate multiplication by a space or centred dot; and division by
Iserson KV. J.-F.-B. Charrie
re: The man behind the “French” gauge.
an oblique stroke (/) or negative exponents
J Emerg Med 1987; 5: 545e8.
Note Po€ll JS. The story of the gauge. Anaesthesia 1999; 54: 575e81.
C Use capitalized L for litre. Lower case letter l may be misread as Whitelaw IA. Measure of all things: the story of measurement
number 1 through the ages. Cincinnati, OH: David & Charles, 2007.
C Use mcg for microgram (e.g. in drug doses, where m may be
misread as m)
C Spelling of unit and prefix names may vary between countriese
e.g. litre, metre, deca (Europe); liter, meter, deka (US)
C The decimal marker is a period (.) in UK, but a comma (,) may be
used in other countries. This ambiguity can lead to errors

Box 2

ANAESTHESIA AND INTENSIVE CARE MEDICINE 18:7 353 Crown Copyright Ó 2017 Published by Elsevier Ltd. All rights reserved.