Documentary News Letter (1944-1945)

DOCUMENTARY NEWS LETTER 31 The Technique of Anaesthesia A series of eleven films made for I.C.I, by the Realist Film Unit in 1944-45. Reviewed by an anaesthetist. Title 1 . Signs and Stages of Anaesthesia 2. Open Drop Ether 3. Nitrous Oxide — Oxygen — Ether Anaesthesia 4. The Carbon Dioxide Absorption Technique 5. Endotracheal Anaesthesia 6. Intravenous Anaesthesia, Part I 7. Intravenous Anaesthesia, Part II 8. Spinal Anaesthesia 9. Resuscitation 10. Operative Shock 1 1 . Handling and Care of the Patient The films were produced by John Taylor and photographed by A. E. Jeakins. They are distributed by the Central Film Library to specialised audiences only. Director Length m nans Margaret Thomson 23 )» >» 30 ,, .. 24 Yvonne Fletcher 22 Margaret Thomson 24 Yvonne Fletcher 30 25 , 35 Rosanne Hunter 16 >» >> 15 ,, iy 25 The primary requirements of the student of medicine, respecting his knowledge of the administration of anaesthetics, have been carefully considered in the preparation of this series of instructional films. Fundamental features of the induction of inhalational anaesthesia are accorded detailed attention. They are best demonstrated, as in films Nos. 1 and 2, during the administration of Open Drop Ether. The signs and differentiated stages of anaesthesia, as induction proceeds, are brought out convincingly, and the clearness of their demonstration cannot fail to stimulate the keen student to elicit them for himself in actual practice. Open Drop Ether is comprehensive in essential technical details. Humorous treatment of the results of unintelligent methods of administering ether emphasises the several serious faults which must be avoided. A very helpful recapitulation of the major instructional points is included in the commentary. Nitrous Oxide — Oxygen — Ether illustrates a method of anaesthesia with apparatus. By means of moving diagram and commentary the mechanical working of anaesthetic machines is lucidly explained. The regulated flow of nitrous oxide and oxygen from the cylinders to the flowmeters and through the apparatus to the patient, and the vaporisation of ether by the gases, is well shown diagrammatically. Fractional rebreathing, a feature which many students find difficult to understand, is made clear, as is also saturation of the tissues by the anaesthetic agent during the maintenance period. The Carbon Dioxide Absorption Technique shows the physical and chemical processes taking place in closed anaesthesia with carbon dioxide absorption. Soda lime canisters, as used in singlephase and two-phase absorption techniques, are described and their working principle illustrated by excellent animation. The use of cyclopropane and the method of "controlled respiration" are also treated clearly. Endotracheal Anaesthesia is the best example in this series of the great value of the film in teaching practical intricacies of technique. Endotracheal intubation, with which the film deals, is an important refinement of anaesthetic practice which, all too frequently, is badly performed by the anaesthetist. One showing of this film, with its excellent photography of the living anatomy of the larynx, its clear explanation by diagram of the exposure of the vocal cords by the laryngoscope and the introduction of a tube into the trachea, will eliminate most of the difficulties which the novice experiences in acquiring the technique and which his teacher has in describing it to him. The general excellence of this film is enhanced by the fact that in it future generations of anaesthetists will be able to see and hear one of the greatest contributors to progress in anaesthetics — I. W. Magill. As befits a method which has acquired great popularity and importance during the recent years of war, the treatment of the two parts of Intravenous Anaesthesia is detailed and extensive. Close observation of the anaesthetised patient, a particularly important factor when intravenous drugs are employed, is so well emphasised throughout this film that the statement that the patient requires little or no attention after operation comes as an anti-climax and must be considered misleading to the inexperienced. The preparation of apparatus, technical points in venepuncture and the controlled injection of the anaesthetic agent are done thoroughly. Difficulties and dangers which may arise are well demonstrated and the ways of treating them are explicit. An omission here, however, is the danger which may arise from coughing or sneezing during certain ophthalmic operations performed under intravenous barbiturate anaesthesia. The scope of intravenous anaesthesia, a debatable field at present, is treated with commendable conservatism which will help to prevent the abuse of the method and protect its status as one of the best and safest methods of anaesthesia. Spinal Anaesthesia (the more correct term, "analgesia", is slow in finding favour) deals with the subject adequately, in so far as the main principles underlying good technique are concerned. It does not, however, reach the high standard of the early films in the series in quality of performance, and leaves room for improvement. Resuscitation is a short film, illustrating methods of resuscitation in cases of respiratory failure and cardiac arrest occurring during anaesthesia. In so far as it depicts all the resources of a well-equipped operating theatre and the skill of an experienced team of surgeons, anaesthetist and nurses coming into timely action, this film is good and serves a useful purpose. Respiratory failure and cardiac arrest, however, have a disconcerting habit of occurring more frequently in the field of minor surgery, in operations such as circumcision and tonsillectomy, and often in outpatient departments where facilities are poor and the medical staff junior and inexperienced. This (Continued at foot of opposite page) WORLD WIDE PICTURES LYSBETH HOUSE, SOHO SQUARE, LONDON, W.l. GERRARD 1736/7/8 welcomes the newly formed CENTRAL OFFICE OF INFORMATION AND ARMY KINEMA CORPORATION May they continue the good work of their wartime counterparts in public information, education and instruction WORLD WIDE PICTURES LTD. A Member of the FEDERATION OF DOCUMENTARY FlUM UNITS