A N E S T H E S I A

I wish to thank Dr. E. Machell and Dr. D. Power for their

co-operation during the collection of these cases.
REFERENCFS
'Gray, T. C. (1948), Post-Grad. med. J., 24, 514.
%eecher, H. K. (1951), Arch. Surg., 62, Feb., 206.
SMushin, W. W. (1945), Proc. roy. SOC.Med., 38, March, 308.
'Millar, J. E. (1948), Tubercle, 29, June, 121.
bl-*arryBrown, A. I., personal communication.
6Lundy, J. S. (1926), Minnesota Med., 9, July, 399.
7Hebert,C. L. (1948), Anesthesiology, 9, Sept., 537.
"Doughty, A. G., and Wylie, W. D. (1951), Proc. roy. SOC.Med., 44, May, 379.
gWatrous, W. G., Davies, F. E., and Anderson, B. M. (1950), Anesthesiology, 11,
Nov., 661.
'ORobson, J. M., and Keele, C. A. Recent Advances in Pharmacology, London, 1950.
llMorton, H, J. V. (1950), Amsthesiu, 5, July, 112.
laMushin, W. W. (1951), Anmth. Sec. roy. SOC.Med., April.
laMushin, W. W. Anosthesia for the Poor Risk, Oxford, 1948.

ELECTRICAL SAFETY IN HOSPITALS

THEAssociation of Anmthetists has received the following communica-
tion from the Ministry of Health :
The Minister wishes to make it known that he has now appointed two
professional qualified electrical engineers who have had active experience
in developing and applying the precautions and safe techniques lying
within the engineering field in environments carrying explosive risks and
whose duty it will be to advise hospital authorities on these and related
matters, for example, shock risks in these situations.
The following will be the main ways in which the advice of these officers
will be made available to hospital authorities :
(1) They will arrange a programme of visits to hospitals, fixing times and
dates by agreement with the secretaries of the Boards of Governors
and Hospital Management Committees. (The Regional Hospital
Board Secretary will be notified of the times and dates fixed for visits
to non-teaching hospitals in his Region. As the number of hospitals
to be visited is large, it may be some time before every Board and
Committee is approached. If, however, some acute problem exists
already (or arises suddenly in the future) and the advice of the
engineers is desired and requested, every effort will be made to arrange
for a visit to be paid to the hospital concerned at an early date.
(2) If a mishap should occur in a hospital and an electrical cause is
suspected, the engineers will be glad to be afforded the opportunity
of a visit to the hospital concerned as soon as possible after the
occurrence to discuss the cause with the staff concerned.
(3) They will also be glad, on request, to advise the technical staffs of
Boards and Committees when construction, reconstruction or re-
equipment of operating theatres, labour rooms, etc., is planned.
The use of suitable materials of construction, and the proper design
and arrangement of electrical and mechanical services and equipment,
can contribute greatly to reducing the risks from electrical causes.
It is apparent that their views can be most helpful if sought at a
very early stage.
Continued on page 33.

23
 ANAZSTHESIA

safe doses its analgesic properties do not approach those of nitrous

oxide. Its place in anaesthesia is a subsidiary one, the main analgesic
agent in nearly all the pethidine techniques so far described being
nitrous oxide. When one is actually using such a safe and effective
analgesic as nitrous oxide-oxygen, it would seem improvident not
to make the most of it. Within limits, the more one uses pethidine
or supplementary doses of barbiturates, the more one has to continue
to use them because the resulting respiratory depression postpones
still further the establishment of equilibrium between the alveolar air
and the anaesthetic mixture delivered by the machine. If, on the
other hand, equilibrium is quickly reached by rhythmic manual over-
ventilation as advocated in this paper, there is rarely any call for
further analgesic drugs.
The technique described has been used for some four years by a
number of my colleagues and myself on several thousand cases and
has proved eminently satisfactory.
The apparatus described was supplied by the British Oxygen Co.,
Manchester.
REFERENCES
lRees, G. J., and Gray, T. C. (1950), Brit. J. Anresth., 22, 83.
"ray, T. C., and Halton, J. (1948), Brit. med. J., 1, 784.
*Slaughter,D. (1950), Arch. int. Pharmucodyn., 83, 143.
'Organe, G., and Broad, R. J. B. (1938), Luncet, 2, 1170.
6Waters, R. M. (1946), J.A.M.A., 130, 909.
ENeff,W., Mayer, E. C., and Thompson, R. (1950), Brit. med. J., 1, 1400.
'Crafoord, C. (193940), Juurn. Thuracic Surg., 9, 243.
Vullen, T. S. (1950), Brit. med. J., 2, 276.

ELECTRICAL SAFETY IN HOSPITALS

Continued from page 23.

When one of these engineers visits a hospital it is clearly important that

he should have the opportunity of discussing the problems which arise
with all the staff concerned, in particular the surgeons, anasthetists,
other operating theatre staff, engineers and physicists. It is hoped that
such discussion will in due course contribute to achieving improved
engineering design and practice and to the development of materials
suitable for use in hazardous environments and of equipment and
appliances which provide greater intrinsic safety without sacrificing
performance.
The reports of these engineers following their visits will be submitted
to the Department, who will subsequently communicate with the Board
or Committee concerned (sending, in the case of a non-teaching hospital,
a copy of their communication also to the appropriate Regional Hospital
Board).
Requests by hospital authorities for the advice of one of these engineers
should be sent to the Engineering Division (M. & E.) Ministry of Health.
33