Description: Segment 1 Opening titles. Caption: Sudden heart failure during anaesthesia may be due to (i) Anoxia of the heart muscle following complete respiratory obstruction or arrest. (ii) The action of the anaesthetic on the heart. What the anaesthetist needs to prepare in case of an emergency an oxygen cylinder, rubber tubing, a catheter, syringes and a needle kept sterile and used in emergencies, ampoules of stimulant drugs, wooden wedge, gauze etc. Two assistants are shown being given tuition in artificial respiration. Firstly they are shown Sylvester's method and then compression of the chest. Mouth-to-mouth inflation is shown (a gauze is placed over the patient's mouth). Alternatively, oxygen is administered via the anaesthetic machine. Time start: 00:00:00:00 Time end: 00:04:05:16 Length: 00:04:05:16 Segment 2 Intertitle: Respiratory obstruction or arrest. When a patient stops breathing there is a short window before the heart stops. A female patient is shown intercut with detail from her patient record, the outcome may depend on the soundness of her heart as well as the clinician's initial choice of anaesthesia. The bed is lowered so circulation to her brain is not impaired, she is turned on her side and then a nasal tube is inserted in case of an obstruction to her throat. Her jaw may slacken (before death) and a laryngeal tube inserted. Artificial respiration is commenced using the compression method. Oxygen is introduced through an anaesthetic mask if introduced directly this could rupture her lungs. Time start: 00:04:05:16 Time end: 00:09:56:19 Length: 00:04:25:00 Segment 3 Intertitle: Cardiac arrest. A male patient is shown, his heart has stopped his skin goes grey and blotchy, his eyes are three-quarters dilated. The anaesthetist has 4 minutes to restart the heart before there is permanent brain damage. Adrenaline is introduced and an endotracheal tube inserted. Artificial respiration with oxygen is commenced. If the heart does not start the aorta is punctured with a needle, this is shown. If this is unsuccessful then the surgeon prepares for heart massage by making an incision. In fact it is noted that the massage is too fast in this clip, then as this is unsuccessful, the diaphram is opened and the heart massaged directly by the surgeon. If within 10 minutes the heart has not restarted then a more violent intervention is needed adrenalin is introduced into the left venricle and massage commenced. The heart begins to beat and artificial respiration continues as the surgeon repairs the wound. A saline drip is introduced and it is described as a satisfactory stimulant for heart cases. The patient is then taken back to the ward, accompanied by the anaesthetist, where he can be observed by a nurse. He is described as still being gravely ill. ICI. The End. Time start: 00:09:56:19 Time end: 00:15:00:00 Length: 00:04:04:08